Treatment Considerations for Depression Research in Older Married Couples: A Dyadic Case Study

Objective Critical gaps remain in understanding optimal approaches to intervening with older couples. The focus of this report is to describe the pros and cons of incorporating spousal dyads into depression-prevention research. Methods In an intervention development study, the authors administered p...

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Bibliographic Details
Published in:The American journal of geriatric psychiatry 2017-04, Vol.25 (4), p.388-395
Main Authors: Stahl, Sarah T., Ph.D, Rodakowski, Juleen, O.T.D., M.S., O.T.R./L, Gildengers, Ariel G., M.D, Reynolds, Charles F., M.D, Morse, Jennifer Q., Ph.D, Rico, Kevin, L.S.W, Butters, Meryl A., Ph.D
Format: Article
Language:English
Subjects:
Aged
Caregivers
Clinical outcomes
Clinical trials
Cognitive Dysfunction - therapy
Cognitive Remediation - methods
Couples
Depression
Depression - psychology
dyads
Female
Humans
Internal Medicine
Male
Mental depression
prevention
Prevention programs
Preventive medicine
Problem solving
Problem Solving - physiology
problem-solving therapy
Spouses
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Summary:Objective Critical gaps remain in understanding optimal approaches to intervening with older couples. The focus of this report is to describe the pros and cons of incorporating spousal dyads into depression-prevention research. Methods In an intervention development study, the authors administered problem-solving therapy (PST) dyadically to participants with mild cognitive impairment (MCI) and their caregivers. Dyads worked with the same interventionist in the same therapy session. The dyadic PST (highlighted in a case example of a husband with MCI and his wife/support person) and the potential feasibility of the program are described. Results The authors found that the wife of the individual with MCI could be trained as a PST coach to help her husband learn and use problem-solving skills. A decrease in depressive symptom severity was observed for the individual with MCI, which was sustained over 12 months of follow-up. Neither the husband nor wife experienced an incident episode of major depression over the course of the study. Conclusion Dyadic interventions need to be further developed in geriatric psychiatry; proven methods such as PST can be modified to include patients' support persons. Recommendations are offered for developing randomized controlled trials that aim to recruit dyads and prevent depression in at-risk older married couples.
ISSN:1064-7481
1545-7214
DOI:10.1016/j.jagp.2016.12.013