Scholarlink

Objectives <p>Comorbid depression is highly prevalent in very old adults hospitalized for acute medical illness. We have previously shown that immediate intervention with cognitive behavioral therapy (CBT) effectively reduces symptoms of depression and anxiety. The present study examines the long-term course and the effect of delayed intervention.</p> Design <p>Randomized, controlled cross-over trial of group CBT.</p> Setting and participants <p>We recruited in-patients of a geriatric university department ≥ 65&#xa0;years with depression (Hospital Anxiety and Depression Scale HADS ≥ 7). Intervention took place after hospital discharge in a day care setting.</p> Methods <p>Patients were randomized to an immediate active intervention group (II) or a waiting list control group with delayed intervention (DI). II patients were invited immediately after discharge to 10 to 15 weekly behavioral group therapy sessions. After 4&#xa0;months (T1), DI patients switched to active intervention, while II were followed under control conditions. Final evaluation took place after 12&#xa0;months (T2). Primary endpoint was improvement in HADS.</p> Results <p>56 patients (82.0 ± 6.2&#xa0;years, HADS 18.8 ± 7.0) were randomized to II, 99 patients (81.9 ± 5.9&#xa0;years, HADS 18.1 ± 8.3) to DI. II patients improved significantly at T1 (HADS 10.4 ± 5.2). Improvement was sustained under control conditions at T2 (11.9 ± 7.8). DI patients did not improve on waiting list (T1 22.9 ± 8.3), but after initiation of active treatment (T2 16.0 ± 8.5) (ANOVA: <i>F =</i> 3.75, <i>p</i> = 0.026). Concomitantly, functional parameters such as Barthel Index and Timed-Up-and-Go differed significantly between groups with better courses in DI patients. Among II patients, 4 (7.1%) deceased and 2 (3.6%) were newly admitted to a nursing home, among DI, 15 (15.2%) and 10 (10.1%) respectively.</p> Conclusions and implications <p>Cognitive behavioral group therapy yields sustained improvement of depressive symptoms in very old geriatric patients, if administered in a multimodal approach immediately following hospitalization for acute medical illness. Concomitant with improvement of depressive symptoms, patients benefit in terms of functional status and medical outcome.</p> Trial registration <p><a href="http://www.germanctr.de">www.germanctr.de</a>; DRKS 00004728; February 12, 2013.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

AIDElong—acute illness and depression in elderly: sustained improvement after group psychotherapy in geriatric patients, a follow-up of longterm effects in a randomized controlled trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月7日

查看全文
  • Jana Hummel,
  • Cecilia Weisbrod,
  • Leila Boesch,
  • Katharina Himpler,
  • Ilona Dutzi,
  • Benito Baldauf,
  • Peter Oster,
  • Daniel Kopf

摘要

Objectives

Comorbid depression is highly prevalent in very old adults hospitalized for acute medical illness. We have previously shown that immediate intervention with cognitive behavioral therapy (CBT) effectively reduces symptoms of depression and anxiety. The present study examines the long-term course and the effect of delayed intervention.

Design

Randomized, controlled cross-over trial of group CBT.

Setting and participants

We recruited in-patients of a geriatric university department ≥ 65 years with depression (Hospital Anxiety and Depression Scale HADS ≥ 7). Intervention took place after hospital discharge in a day care setting.

Methods

Patients were randomized to an immediate active intervention group (II) or a waiting list control group with delayed intervention (DI). II patients were invited immediately after discharge to 10 to 15 weekly behavioral group therapy sessions. After 4 months (T1), DI patients switched to active intervention, while II were followed under control conditions. Final evaluation took place after 12 months (T2). Primary endpoint was improvement in HADS.

Results

56 patients (82.0 ± 6.2 years, HADS 18.8 ± 7.0) were randomized to II, 99 patients (81.9 ± 5.9 years, HADS 18.1 ± 8.3) to DI. II patients improved significantly at T1 (HADS 10.4 ± 5.2). Improvement was sustained under control conditions at T2 (11.9 ± 7.8). DI patients did not improve on waiting list (T1 22.9 ± 8.3), but after initiation of active treatment (T2 16.0 ± 8.5) (ANOVA: F = 3.75, p = 0.026). Concomitantly, functional parameters such as Barthel Index and Timed-Up-and-Go differed significantly between groups with better courses in DI patients. Among II patients, 4 (7.1%) deceased and 2 (3.6%) were newly admitted to a nursing home, among DI, 15 (15.2%) and 10 (10.1%) respectively.

Conclusions and implications

Cognitive behavioral group therapy yields sustained improvement of depressive symptoms in very old geriatric patients, if administered in a multimodal approach immediately following hospitalization for acute medical illness. Concomitant with improvement of depressive symptoms, patients benefit in terms of functional status and medical outcome.

Trial registration

www.germanctr.de; DRKS 00004728; February 12, 2013.