Objectives-More than half of older adults with major depressive disorder require extended treatment because of incomplete response during acute treatment. This study characterizes the effect of anxiety on remission during extended treatment for partial responders.Methods-Following 6 weeks of escitalopram 10mg/day + Depression Care Management (DCM), 124 partial-responders (Hamilton Rating Scale for Depression (HRSD) scores of 11-14) were randomly assigned to receive extended treatment with escitalopram 20 mg/day + DCM with or without interpersonal psychotherapy (IPT) for 16 weekly sessions. Remission was defined as three consecutive weekly scores ≤7 on the HRSD. We assessed concurrent symptoms of anxiety using the Hamilton Rating Scale for Anxiety (HRSA) at pre-treatment and after 6 weeks. We conducted Cox regression analysis of time to remission and logistic modeling of rates of remission. We also explored whether anxiety severity altered any impact of IPT.Results-Pre-treatment anxiety was not associated with time to or rates of remission during 16 weeks of extended treatment. In contrast, more severe psychological symptoms of anxiety after 6 weeks of treatment was associated with both longer time to and lower rates of remission. However, there was no evidence that IPT showed any differential effects as a function of anxiety.Conclusions-In partial responders to six weeks of lower-dose escitalopram and DCM, planning for extended treatment should account for psychological symptoms of anxiety.
Aims: Although physical activity (PA) is universally recommended, most adults are not regular exercisers. Interactive video dance is a novel form of PA in widespread use among young adults, but interest among adults is not known. Postmenopausal women are an appropriate target for interventions to promote PA because they have an increased risk of health problems related to sedentary behavior. We explored perceived advantages and disadvantages of video dance as a personal exercise option in postmenopausal women. Methods: Forty sedentary postmenopausal women (mean age AE SD 57 AE 5 years), were oriented in eight small groups to interactive video dance, which uses a force-sensing pad with directional panels: the player steps on the panels in response to arrows scrolling on a screen, synchronized to music. Perceived advantages and disadvantages were elicited through a nominal group technique (NGT) process.
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