The DOI matches its Crossref record; 81 of the 81 references it cites were found in a registry or an index.
Problem-Solving Therapy and Supportive Therapy in Older Adults With Major Depression and Executive Dysfunction: Effect on Disability
Open accessAbstract
CONTEXT: Older patients with depression and executive dysfunction represent a population with significant disability and a high likelihood of failing pharmacotherapy. OBJECTIVES: To examine whether problem-solving therapy (PST) reduces disability more than does supportive therapy (ST) in older patients with depression and executive dysfunction and whether this effect is mediated by improvement in depressive symptoms. DESIGN: Randomized controlled trial. SETTING: Weill Cornell Medical College and University of California at San Francisco. PARTICIPANTS: Adults (aged >59 years) with major depression and executive dysfunction recruited between December 2002 and November 2007 and followed up for 36 weeks. Intervention Twelve sessions of PST modified for older depressed adults with executive impairment or ST. Main Outcome Measure Disability as quantified using the 12-item World Health Organization Disability Assessment Schedule II. RESULTS: Of 653 individuals referred to this study, 221 met the inclusion criteria and were randomized to receive PST or ST. Both PST and ST led to comparable improvement in disability in the first 6 weeks of treatment, but a more prominent reduction was noted in PST participants at weeks 9 and 12. The difference between PST and ST was greater in patients with greater cognitive impairment and more previous episodes. Reduction in disability paralleled reduction in depressive symptoms. The therapeutic advantage of PST over ST in reducing depression was, in part, due to greater reduction in disability by PST. Although disability increased during the 24 weeks after the end of treatment, the advantage of PST over ST was retained. CONCLUSIONS: These results suggest that PST is more effective than ST in reducing disability in older patients with major depression and executive dysfunction, and its benefits were retained after the end of treatment. The clinical value of this finding is that PST may be a treatment alternative in an older patient population likely to be resistant to pharmacotherapy. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00052091.
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“Problem solving therapy was more effective that supportive therapy in reducing depression and disability in older adults with DED162,163, a syndrome with poor response to antidepressants32–38,164.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [163]
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Malhi, G. S., Bassett, D., Boyce, P., Bryant, R., Fitzgerald, P. B., Fritz, K., Hopwood, M., Lyndon, B., Mulder, R., Murray, G., et al. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415617657 · Cited by 842
“, 2006) and problem-solving therapy (Alexopoulos et al., 2011).”
BackgroundMalhi, G. S., Bell, E., Bassett, D., Boyce, P., Bryant, R., Hazell, P., Hopwood, M., Lyndon, B., Mulder, R., Porter, R., et al. (2021) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867420979353 · Cited by 614
Mechanisms and treatment of late-life depression
Alexopoulos, G. S. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0514-6 · Cited by 592
Self-citationWorld Health Organization disability assessment schedule 2.0: An international systematic review
Federici, S., Bracalenti, M., Meloni, F., & Luciano, J. V. (2016) · Disability and Rehabilitation · doi:10.1080/09638288.2016.1223177 · Cited by 542
Taylor, W. D. (2014) · New England Journal of Medicine · doi:10.1056/nejmcp1402180 · Cited by 423
Metadata
- Authors
- Alexopoulos, G. S., Raue, P. J., Kiosses, D. N., Mackin, R. S., Kanellopoulos, D., McCulloch, C., & Areán, P. A.
- Affiliations
- Weill Cornell Medicine (US)
- University of California, San Francisco (US)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2011-01-03
- Volume
- 68
- Issue
- 1
- Pages
- 33
- ISSN
- 0003-990X (ISSN-L)
- PMC
- PMC3018861
- OpenAlex
- W2002361530
- Cited by
- 199
- References
- 75
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 5 · 2023: 6 · 2022: 11 · 2021: 12 · 2020: 22 · 2019: 13 · 2018: 13 · 2017: 16 · 2016: 11 · 2015: 19 · 2014: 18 · 2013: 22 · 2012: 14
- FWCI
- 20.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eli Lilly and Company
- Sanofi
- National Institute of Mental Health (R01MH075897, P30MH085943, R01MH064099, K24MH074717, R01MH063982)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- problem-solving therapy, supportive therapy, major depressive disorder, older adults, executive dysfunction, cognitive impairment, disability, depressive symptoms, treatment-resistant depression, psychotherapy
- MeSH terms
- Aged, Aged, 80 and over, Cognition Disorders, Major Depressive Disorder, Disability Evaluation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Person-Centered Psychotherapy, Problem Solving, Psychotherapy, Social Support, Cognitive Behavioral Therapy, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders, Executive Function
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