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Problem-solving therapy reduces disability more than supportive therapy in older adults with major depression and executive dysfunction

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Question: Is problem-solving therapy (PST) better than supportive therapy (ST) for reducing disability in older adults with depression and executive dysfunction?

Patients: 221 older adults (aged >59 years) with major non-psychotic depression (Structured Clinical Interview for Axis-I DSM-IV disorders), 24-item Hamilton Depression Rating Scale score ≥20, Mini-Mental State Examination score ≥24, Mattis Dementia Rating Scale initiation/preservation domain (DRS-IP) score ≤33 and Stroop Colour-Word Test score ≤25.

Setting: Two research centres (Weill Cornell Medical College and University of California at San Francisco), USA; 2002–2007.

Intervention: PST versus ST for 12 weeks. PST was delivered individually over 12, once-weekly sessions and followed the unpublished manual, Social Problem Solving Therapy for Depression and Executive Dysfunction, which is based on setting and achieving goals, creating action plans and evaluating the accomplishment of goals. The first five sessions were educational, the subsequent seven based on enhancing skills and the final two on a relapse-prevention plan. Experienced clinical psychologists or licensed social workers received specific training in the delivery of each intervention.

Outcomes: Disability assessed using the …

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