Journal
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
Volume 16, Issue 6, Pages 460-468Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JGP.0b013e318165db95
Keywords
depression prevention; indicated preventive intervention; elderly; African American; translation
Categories
Funding
- NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES [P60MD000207] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [T32MH019986, P30MH071944] Funding Source: NIH RePORTER
- NIMHD NIH HHS [P60 MD000207, P60 MD000-207] Funding Source: Medline
- NIMH NIH HHS [P30 MH071944, T32 MH19986, P30 MH071944-05, T32 MH019986] Funding Source: Medline
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Objective: The authors detail the public health need for depression prevention research and the decisions made in designing an experiment testing problem solving therapy as indicated preventive intervention for high-risk older adults with sub-syndromal depression. Special attention is given to the recruitment of African Americans because of well-documented inequalities in mental health services and depression treatment outcomes between races. Methods: A total of 306 subjects (half white, half African American) with scores of 16 or higher on the Center for Epidemiological Studies of Depression Scale, but with no history of major depressive disorder in the past 12 months, are being recruited and randomly assigned to either problem solving therapy-primary care or to a dietary education control condition. Time to, and rate of, incident episodes of major depressive disorder are to be modeled using survival analysis. Level of depressive symptoms will be analyzed via a mixed models approach. Results: Twenty-two subjects have been recruited into the study, and to date eight have completed the randomly assigned intervention and postintervention assessment. Four of 22 have exited after developing major depressive episodes. None have complained about study procedures or demands. Implementation in a variety of community settings is going well. Conclusion: The data collected to date support the feasibility of translating from epidemiology to RCT design and implementation of empirical depression prevention research in later life.
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