Problem-solving versus cognitive restructuring of medically ill seniors with depression (PROMISE-D trial) study protocol and design 英文参考文献.docVIP

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Problem-solving versus cognitive restructuring of medically ill seniors with depression (PROMISE-D trial) study protocol and design 英文参考文献.doc

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Problem-solving versus cognitive restructuring of medically ill seniors with depression (PROMISE-D trial) study protocol and design 英文参考文献

Sharpeetal.BMCPsychiatry2012,12:207 /1471-244X/12/207 STUDY PROTOCOL OpenAccess Problem-solvingversuscognitiverestructuringof medicallyillseniorswithdepression (PROMISE-Dtrial):studyprotocolanddesign LouiseSharpe1*,CatherineBGittins1,HelenMCorreia2,TanyaMeade3,4,MichaelKNicholas5,PatrickJRaue6, SarahMcDonald1andPatriciaAAreán7 Abstract Background:WithanageingpopulationinmostWesterncountries,peoplearelivinglongerbutoftenwithoneor morechronicphysicalhealthproblems.Olderpeopleinphysicallypoorhealthareatgreaterriskofdeveloping clinicaldepression.CognitiveBehaviouralTherapy(CBT)andProblemSolvingTherapy(PST)havebothbeenfound tobeefficaciousintreatinglate-lifedepression,howeverpatientswith“multi-morbidity”(i.e.morethanonechronic condition)areoftenexcludedfromthesetrials.TheaimofthisstudyistocomparetheefficacyofCBTandPSTin treatingolderadultswhohaveoneormorechronicphysicalhealthconditionsandadiagnosabledepressive disorder.Thisstudywillbethefirsttoexplicitlytargetthetreatmentofdepressioninolderpeopleinprimarycare settingspresentingwitharangeofhealthproblemsusingbehaviouralinterventions. Methods/design:ThePROMISE-Dstudyisarandomisedcontrolledtrialoftwoevidence-basedtreatmentsfor late-lifemajororminordepressionforpatientswhoalsohaveatleastoneco-morbidchronichealthproblem. Participantswillberandomisedtotwoactiveinterventions(PSTorCBT)orenhancedtreatment-as-usual(E-TAU). Primaryoutcomeswillbedepressiondiagnosticstatusandseverityofdepression(accordingtotheHamilton DepressionRatingScaleandtheGeriatricDepressionScale).Secondaryoutcomeswillbeanxietyseverity,qualityof lifeandhealthcareutilisation.Assessmentswillbeconductedbyaresearcherwhoremainsblindtothepatient’s treatmentallocationandwillbeconductedpreandpost-treatmentandatsixand12monthsfollow-up.Health careutilisationwillbeassessedthroughoutatwoyearperiodfollowingentrytothetrial.Executivefunction, ruminationandemotionregulationwillalsobemeasuredtodeterminetheimpactofthesefactorsontreatment responseintwotreatmentgroups. Discussion: