Community-Integrated Home-Based Depression Treatment in Older Adults

Abstract

LINICALLY SIGNIFICANT DEPRESsion affects 15% to 20% of elderly individuals in the United States. 1,2 Older individuals are less likely than younger adults to have major depression 3 but have comparable or higher rates of less severe depressive disorders such as dysthymia and minor depression. Dysthymia is a chronic depressive syndrome persisting for at least 2 years. 4 According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Appendix of Criteria Sets and Axes Provided for Further Study, minor depression is depressed mood and/or significant loss of interest, plus 1 to 3 other depressive symptoms present nearly every day for at least 2 weeks, occurring in the absence of dysthymia. 4(pp719-721) Minor depression and dysthymia both lead to significant disability. 5,6 Accumulating evidence from primary care set-

Behavioral and Psychosocial Interventions in Diabetes

“…Problem-solving ability is associated with improved health outcomes, and problem-solving interventions are often effective in improving health outcomes (30,44). Problem solving involves a broad range of activities; in this context, we highlight the process that patients must engage in to attain their behavior change goals, specifically those involved in dealing with the barriers to change.…”

“…Rewards for achieving various levels of success can serve as incentive (7). These rewards should be something pleasant (44) but not to the opposition of the success (i.e., overeating should not be the reward for not overeating). Explicit criteria for receiving rewards should be stated in the written contract.…”

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

“…Given that this census-based sample found that 1 in 10 older adults were characterized by a profile of histories of serious suicidal ideation/behavior in the absence of current psychological distress other than recent death wishes, research is needed to examine the potential benefits of regular screening of suicide risk among all older adults, not just those with depression. Research is also needed regarding clinical management of those older adults presenting with death wishes in the absence of significant depression—specifically, whether treatments shown to be effective for older adults with suicidal ideation and depression 31–33 are useful and whether treatments targeting factors other than depression (e.g., targeting loneliness 34 ) are also useful.…”

Telemedicine for Depression in Older People Living with HIV

“…Older PLWH often experience mild to moderate depressive disorders such as dysthymic disorder and "minor" depression [23]. Some studies indicate depression prevalence as high as 52% for older PLWH [24], while others show that older PLWH are five times more likely to experience depression compared to HIV-negative peers [25].…”