Preventing Late-life Depression in Age-related Macular Degeneration

Overview

Journal Am J Geriatr Psychiatry

Publisher Elsevier

Specialty Geriatrics

Date 2008 Jun 3

PMID 18515689

Citations 19

Authors

Barry W Rovner

Robin J Casten

Affiliations

Soon will be listed here.

Abstract

Objective: To determine whether problem-solving treatment (PST) can prevent depressive disorders in patients with age-related macular degeneration (AMD).

Design: Two hundred six patients with AMD were randomly assigned to PST (n = 105) or usual care (n = 101). PST therapists delivered six PST sessions over 8 weeks in subjects' homes.

Measurements: Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition Diagnoses of Depressive Disorders, Hamilton Depression Rating Scale scores, and rates of relinquishing valued activities were assessed at 2 months for short-term effects and 6 months for maintenance effects.

Results: The 2-month incidence rate of depressive disorders in PST-treated subjects was significantly lower than controls (11.6% versus 23.2%, respectively; OR = 0.43; 95% CI [0.20, 0.95]). PST also reduced the odds of relinquishing a valued activity (OR = 0.48; 95% CI [0.25, 0.96]); this effect mediated the relationship between treatment group and depression. By 6 months most earlier observed benefits had diminished. Secondary analyses showed that a minimal level of depressive symptoms were disabling and predicted incident depressive disorders.

Conclusion: PST prevented depressive disorders and loss of valued activities as a short-term treatment but these benefits were not maintained over time. To sustain PST's effect, an intervention that uses a problem-solving framework to enhance rehabilitative skills may be necessary.

Citing Articles

Prevention of depression in adults with long-term physical conditions.

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Visual Impairment and Mental Health: Unmet Needs and Treatment Options.

Demmin D, Silverstein S Clin Ophthalmol. 2020; 14:4229-4251.

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Low vision rehabilitation for better quality of life in visually impaired adults.

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Challenges and Solutions for Depression Prevention Research: Methodology for a Depression Prevention Trial for Older Adults with Knee Arthritis and Emotional Distress.

Karp J, Dew M, Wahed A, Fitzgerald K, Bolon C, Weiner D Am J Geriatr Psychiatry. 2016; 24(6):433-43.

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McCusker S, Koola M Prim Care Companion CNS Disord. 2015; 17(4).

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