|Title||Comparing the streamlined psychotherapy "Engage" with problem-solving therapy in late-life major depression. A randomized clinical trial.|
|Publication Type||Journal Article|
|Year of Publication||2020|
|Authors||Alexopoulos GS, Raue PJ, Banerjee S, Marino P, Renn BN, Solomonov N, Adeagbo A, Sirey JAnne, Hull TD, Kiosses DN, Mauer E, Areán PA|
|Date Published||2020 Jul 01|
Effective psychotherapies for late-life depression are underutilized, mainly because of their complexity. "Engage" is a novel, streamlined psychotherapy that relies on neurobiology to identify core behavioral pathology of late-life depression and targets it with simple interventions, co-designed with community therapists so that they can be delivered in community settings. Consecutively recruited adults (≥60 years) with major depression (n = 249) were randomly assigned to 9 weekly sessions of "Engage" or to the evidence-based Problem-Solving Therapy (PST) offered by 35 trained community social workers and assessed by blind raters. "Engage" therapists required an average of 30% less training time to achieve fidelity to treatment than PST therapists and had one-third of the PST therapists' skill drift. Both treatments led to reduction of HAM-D scores over 9 weeks. The mixed effects model-estimated HAM-D ratings were not significantly different between the two treatments at any assessment point of the trial. The one-sided 95% CI for treatment-end difference was (-∞, 0.07) HAM-D points, indicating a non-inferiority margin of 1.3 HAM-D points or greater; this margin is lower than the pre-determined 2.2-point margin. The two treatment arms had similar response (HR = 1.08, 95% CI (0.76, 1.52), p = 0.67) and remission rates (HR = 0.89, 95% CI (0.57, 1.39), p = 0.61). We conclude that "Engage" is non-inferior to PST. If disseminated, "Engage" will increase the number of therapists who can reliably treat late-life depression and make effective psychotherapy available to large numbers of depressed older adults.
|Alternate Journal||Mol. Psychiatry|
|Grant List||R01 MH102252 / MH / NIMH NIH HHS / United States |
T32 MH019132 / MH / NIMH NIH HHS / United States
P50 MH113838 / MH / NIMH NIH HHS / United States
R01 MH102304 / MH / NIMH NIH HHS / United States
P50 MH115837 / MH / NIMH NIH HHS / United States
Comparing the streamlined psychotherapy "Engage" with problem-solving therapy in late-life major depression. A randomized clinical trial.
Submitted by chz4003 on July 22, 2020 - 2:43pm