Two Behavioral Interventions for Patients with Major Depression and Severe COPD
Open accessAbstract
Objective Personalized Intervention for Depressed Patients with COPD (PID-C), a treatment mobilizing patients to participate in their care, was found more effective than usual care. To further improve its efficacy, we developed a Problem Solving-Adherence (PSA) intervention integrating problem solving into adherence enhancement procedures. We tested the hypothesis that PSA is more effective than PID-C in reducing depressive symptoms. Exploratory analyses sought to identify patients with distinct depressive symptom trajectories and compare their clinical profiles.Design Randomized controlled trial.Setting Acute inpatient rehabilitation and community.Participants A total of 101 diagnosed with chronic obstructive pulmonary disease (COPD) and major depression after screening 633 consecutive admissions for acute inpatient rehabilitation.Intervention Fourteen sessions of PID-C versus PSA over 26 weeks.Measurements 24-item Hamilton Depression Rating Scale.Results PSA was not more efficacious than PID-C in reducing depressive symptoms. Exploratory latent class growth modeling identified two distinct depressive symptoms trajectories. Unlike patients with unfavorable course (28%) who remained symptomatic, patients with favorable course (72%) had a decline of symptoms during the hospitalization followed by a milder decline after discharge. Patients with unfavorable course were younger and had greater scores in disability, anxiety, neuroticism, and dyspnea related limitation in activities and lower self-efficacy scores.Conclusions Both interventions led to sustained improvement depressive symptoms. PID-C matches the skills of clinicians employed by community rehabilitation programs and can be integrated in the care of depressed COPD patients. Patients with severe disability, anxiety, neuroticism, and low self-efficacy are at risk for poor outcomes and in need of close follow-up and targeted interventions. .
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Personalized interventions aiming to increase adherence to treatment for major depression and COPD improved both depressive symptoms and disability.
“Personalized interventions aiming to increase adherence to treatment for major depression and COPD improved both depressive symptoms and disability165–167.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [165]
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- Authors
- Alexopoulos, G. S., Sirey, J. A., Banerjee, S., Kiosses, D. N., Pollari, C., Novitch, R. S., Artis, A., & Raue, P. J.
- Affiliations
- Cornell University (US)
- Burke Rehabilitation Hospital (US)
- Corresponding author
- Alexopoulos, George S.
- ORCID
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-11
- Volume
- 24
- Issue
- 11
- Pages
- 964-974
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC5069195
- OpenAlex
- W2477740780
- Cited by
- 33
- References
- 40
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 8 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 1
- FWCI
- 3.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIMH (R01 MH076829, P30 MH085943)
- Sanchez Foundation
- Will Rogers Institute
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- major depressive disorder, chronic obstructive pulmonary disease, behavioral interventions, problem solving, medication adherence, patient participation in care, personalized interventions, depressive symptom trajectories, inpatient rehabilitation, self-efficacy, anxiety, neuroticism, dyspnea, disability
- MeSH terms
- Neuroticism, Aged, Aged, 80 and over, Anxiety, Major Depressive Disorder, Depressive Disorder, Major, Dyspnea, Female, Hospitalization, Humans, Male, Middle Aged, Problem Solving, Severity of Illness Index, Treatment Outcome, Self Efficacy, Pulmonary Disease, Chronic Obstructive
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