Problem-solving therapy for major depressive disorders in older adults: an updated systematic review and meta-analysis of randomized controlled trials

Shang, Pingping; Cao, Xuelian; You, Simiao; Feng, Xuezhu; Li, Na; Jia, Yong

doi:10.1007/s40520-020-01672-3

Cited by 8 publications

(6 citation statements)

References 43 publications

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“…This design decision was taken to ensure a significantly large number of patients in both treatment arms to address the primary research question of the study, namely, the specific efficacy of CBT in LLD. However, symptom changes of waiting-list LLD control groups have been reported in the literature, and the effects we observed in both treatment arms of our study are substantially larger [15,[32][33][34][35]. A further limitation is that treatment integrity was not assessed throughout all rated videos by multiple raters using a measure previously shown to be reliable and valid as well as in this sample.…”

Section: Discussionmentioning

confidence: 61%

Cognitive Behavioral Therapy for Late-Life Depression (CBTlate): Results of a Multicenter, Randomized, Observer-Blinded, Controlled Trial

Dafsari

Bewernick

Böhringer

et al. 2023

Psychother Psychosom

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Introduction: Different psychotherapeutic interventions for late-life depression (LLD) have been proposed, but their evaluation in large, multicenter trials is rare. Objective: The present study evaluated the efficacy of a specific cognitive behavioral therapy (CBT) for LLD (LLD-CBT) in comparison with a supportive unspecific intervention (SUI), both administered in a specialist psychiatric outpatient setting. Methods: In this randomized, controlled, parallel group trial, we recruited participants (≥60 years) with moderate to severe depression at 7 trial sites in Germany. Participants were randomly assigned to the LLD-CBT or SUI group. The primary outcome was depression severity at the end of treatment measured by change on the Geriatric Depression Scale (GDS). Secondary outcomes included change in observer-rated depression, anxiety, sleep ratings, and quality of life throughout the treatment phase and at 6-month follow-up. Results: Between October 1, 2018, and November 11, 2020, we randomly assigned 251 patients to either LLD-CBT (n = 126) or SUI (n = 125), of whom 229 provided primary-outcome data. There was no significant between-group difference in the change in GDS scores at the end of treatment (estimated marginal mean difference: −1.01 [95% CI: −2.88 to 0.86]; p = 0.287). Secondary analyses showed significant improvements in several outcomes after 8 weeks and at follow-up in both treatment arms. Conclusions: Our data suggest that LLD-specific CBT and a supportive unspecific treatment both provide clinical benefit in patients with moderate to severe LLD without evidence for superiority of LLD-CBT.

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Section: Discussionmentioning

confidence: 61%

Cognitive Behavioral Therapy for Late-Life Depression (CBTlate): Results of a Multicenter, Randomized, Observer-Blinded, Controlled Trial

Dafsari

Bewernick

Böhringer

et al. 2023

Psychother Psychosom

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“…This study revealed the effectiveness of PST on depression in older adults who lived in the nursing home setting, consistent with the above findings. MPST can improve older adults' misconceptions about daily hassles, reduces attitudes of avoiding problems and improves their problem-solving skills, which promotes stress reduction, enhances self-management confidence, and decrease depression (Shang et al, 2021). Separately, older adults receiving PST still maintained significantly lower depression than usual care at T3, demonstrating that the beneficial effects of MPST remained invariable at 3 months post-intervention.…”

Section: Discussionmentioning

confidence: 92%

“…As a non-pharmacological treatment method, problemsolving therapy (PST) is structured, systematic, and widely applicable, and has been widely used in the treatment of depressed patients with effective results (Cuijpers et al, 2018). PST is a problem-oriented approach to guide depressed patients to identify their problems, supplemented by problem-solving skills correctly (e.g., setting reasonable goals, brainstorming methods to identify solutions).Therapists use PST to help individuals better manage their life problems and improve their daily life experiences, thus effectively solving problems, improving their coping skills and reducing depressive symptoms caused by complex problemsolving (Alexopoulos et al, 2016;Shang et al, 2021). Alexopoulos et al (2016) conducted a randomized controlled trial of problemsolving therapy versus supportive psychological interventions in homebound elderly depressed patients and showed that problemsolving therapy was superior to supportive psychological interventions in improving depression in the elderly.…”

Section: Introductionmentioning

confidence: 99%

The effects of modified problem-solving therapy on depression, coping, and self-efficacy in elderly nursing home residents

Zhang

et al. 2023

Front. Psychol.

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BackgroundWith the increasing trend of aging, the mental health problems of the elderly require urgent attention. Depression is a common psychological problem of the elderly, which affects their quality of life and physical health. Problem-solving therapy can effectively improve depression in the elderly, but there are few studies on problem-solving therapy for depression in the elderly in China. The purpose of this study was to evaluate the effects of modified problem-solving therapy (MPST) on depression, coping and self-efficacy in elderly nursing home residents.MethodsThis study was a randomized controlled trial. A total of 60 older adults from two nursing homes were recruited to participate in this study and randomly assigned to the intervention group (MPST) or the control group (usual care). The intervention lasted 8 weeks, and information on depression, coping skills, and self-efficacy was collected before the intervention, immediately after the intervention, and 3 months after the intervention. Repeated measures ANOVA was used to compare changes at multiple time points between the two groups. If the interaction effect (group * time) was significant, independent samples t-test was used to compare the differences in outcome indicators between groups at post-intervention and 3 months post-intervention.ResultsCompared to the control group, depression scores in the intervention group were significantly lower at the end of the intervention and remained significantly lower than the control group 3 months post-intervention (p < 0.05). Negative coping and self-efficacy in the intervention group also improved significantly at the end of the intervention, and 3 months post-intervention, while positive coping in the two groups did not differ significantly at 3 months post-intervention.ConclusionThe findings of this study suggest that MPST could be beneficial in reducing depressive symptoms and enhancing positive coping and self-efficacy levels in older adults in nursing homes.

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“…It assists patients in internalizing four basic problemsolving skills, known as the PST protocol: first, defining the problem; second, brainstorming possible solutions; third, evaluating and selecting the most promising solution; and fourth, implementing the preferred solution and reflecting on the outcome [23]. Through these systematic steps, therapists enable individuals to effectively address problems, refine coping skills, and alleviate depressive symptoms [24][25][26][27][28]. Therefore, PST contributes to improved QoL and physical well-being [29].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Problem-Solving Therapy in Improving Patient Mental Health, Function, Quality of Life, and Mortality Post-Stroke: A Systematic Review

Le,

Honma,

Annaka

et al. 2024

Behavioral Sciences

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Problem-solving therapy (PST) is a potential psychological intervention aimed at preventing and treating psychological issues in stroke patients, although its efficacy is not clearly established. This systematic review assessed the effectiveness of PST in improving mental health, functioning, quality of life, and mortality in this population. Six databases were searched for literature indexed through March 2024, including the Cochrane Library, PubMed, Scopus, CINAHL, NeuroBITE, and OTseeker. This review (CRD42023483757) followed the PRISMA guidelines and the Cochrane Library Handbook, utilizing the RoB 2 tool and GRADE system to assess the quality of the evidence. It included eight randomized controlled trials (RCTs) involving 1249 patients with stroke. Among them, five RCTs showed that PST might improve depression. Additionally, individual RCTs demonstrated the efficacy of PST in addressing patient anxiety, apathy, and coping. With respect to mental health, PST might affect patient quality of life and mortality. However, the results of four RCTs demonstrated no effect of PST on patient functioning. The quality of evidence for the outcomes ranged from very low to high. PST may improve mental health, quality of life, and mortality in patients with stroke.

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Problem-solving therapy for major depressive disorders in older adults: an updated systematic review and meta-analysis of randomized controlled trials

Cited by 8 publications

References 43 publications

Cognitive Behavioral Therapy for Late-Life Depression (CBTlate): Results of a Multicenter, Randomized, Observer-Blinded, Controlled Trial

Cognitive Behavioral Therapy for Late-Life Depression (CBTlate): Results of a Multicenter, Randomized, Observer-Blinded, Controlled Trial

The effects of modified problem-solving therapy on depression, coping, and self-efficacy in elderly nursing home residents

Effectiveness of Problem-Solving Therapy in Improving Patient Mental Health, Function, Quality of Life, and Mortality Post-Stroke: A Systematic Review

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