Two-year follow-up of a randomized controlled trial of stepped care cognitive behavioral therapy to prevent recurrence of depression in an older population
Article first published online: 23 JUL 2013
Copyright © 2013 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 29, Issue 3, pages 317–325, March 2014
How to Cite
Apil, S. R. A., Spinhoven, P., Haffmans, P. M. J. and Hoencamp, E. (2014), Two-year follow-up of a randomized controlled trial of stepped care cognitive behavioral therapy to prevent recurrence of depression in an older population. Int. J. Geriat. Psychiatry, 29: 317–325. doi: 10.1002/gps.4010
- Issue published online: 11 FEB 2014
- Article first published online: 23 JUL 2013
- Manuscript Accepted: 28 JUN 2013
- Manuscript Revised: 8 JUN 2013
- Manuscript Received: 31 DEC 2012
- ZonMw. Grant Number: 2620.003
- Fonds NutsOhra. Grant Number: SNO-T-07-80
- cognitive behavioral therapy;
- older people;
- stepped care;
- randomized controlled trial
This study aims to determine the long-term effect of a stepped care cognitive behavioral therapy prevention program for depression in older people and the factors predicting or moderating outcome.
In a randomized controlled trial, 136 participants, aged 55 years or older, who had been treated for depression, received during 12 months a stepped care program (SCP) or care as usual (CAU) and were then followed up for a second year. Outcome was defined as the start of a new mental health treatment for depression in a specialized outpatient setting, as recorded in the patients' electronic medical records.
Of the 123 patients, 38 required new mental health treatment. Survival analysis showed that participants in SCP (n = 27) required new treatment significantly more than patients receiving CAU (n = 11). Negative life events in the last year were predictive for new treatment in CAU but not in SCP.
An SCP seems to lower the threshold for new specialized mental health treatment for depression, whereas new treatment in CAU patients occurs more often in reaction to recent life events. Copyright © 2013 John Wiley & Sons, Ltd.