Trial reportThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2016
Clinical Case Management versus Case Management with Problem-Solving Therapy in Low-Income, Disabled Elders with Major Depression: A Randomized Clinical Trial.
Trial report in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Non-pharmacological interventions for depression/anxiety in older adults with physical comorbidities affecting functioning: systematic review and meta-analysis.International psychogeriatrics · 2019Pooled it
- Depression Agency-Based Collaborative: Effect of Problem-Solving Therapy on Risk of Common Mental Disorders in Older Adults With Home Care Needs.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2019Trial
- Improving late life depression and cognitive control through the use of therapeutic video game technology: A proof-of-concept randomized trial.Depression and anxiety · 2017Trial
- Effects of Problem-Solving Therapy and Clinical Case Management on Disability in Low-Income Older Adults.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2015Trial
- Effectiveness of Problem-Solving Therapy in Improving Patient Mental Health, Function, Quality of Life, and Mortality Post-Stroke: A Systematic Review.Behavioral sciences (Basel, Switzerland) · 2024Review
- The effects of modified problem-solving therapy on depression, coping, and self-efficacy in elderly nursing home residents.Frontiers in psychology · 2022Article
- Mechanisms and treatment of late-life depression.Translational psychiatry · 2019Review
- Pharmacist-Led Drug Therapy Problem Management in an Interprofessional Geriatric Care Continuum: A Subset of the PIVOTS Group.American health & drug benefits · 2018Article
- A 12-Week Multi-Domain Lifestyle Modification to Reduce Depressive Symptoms in Older Adults: A Preliminary Report.Psychiatry investigation · 2018Article
- Advances in Psychotherapy for Depressed Older Adults.Current psychiatry reports · 2017Review
- Psychosocial Treatment Options for Major Depressive Disorder in Older Adults.Current treatment options in psychiatry · 2017Article
- Conducting a fully mobile and randomised clinical trial for depression: access, engagement and expense.BMJ innovations · 2016Article
- Intervention Research in Late-Life Depression: Challenges and Opportunities.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo test the hypotheses that (1) clinical case management integrated with problem-solving therapy (CM-PST) is more effective than clinical case management alone (CM) in reducing depressive symptoms of depressed, disabled, impoverished patients and that (2) development of problem-solving skills mediates improvement of depression.
methodsThis randomized clinical trial with a parallel design allocated participants to CM or CM-PST at 1:1 ratio. Raters were blind to patients' assignments. Two hundred seventy-one individuals were screened and 171 were randomized to 12 weekly sessions of either CM or CM-PST. Participants were at least 60 years old with major depression measured with the 24-item Hamilton Depression Rating Scale (HAM-D), had at least one disability, were eligible for home-based meals services, and had income no more than 30% of their counties' median.
resultsCM and CM-PST led to similar declines in HAM-D over 12 weeks (t = 0.37, df = 547, p = 0.71); CM was noninferior to CM-PST. The entire study group (CM plus CM-PST) had a 9.6-point decline in HAM-D (t = 18.7, df = 547, p <0.0001). The response (42.5% versus 33.3%) and remission (37.9% versus 31.0%) rates were similar (χ(2) = 1.5, df = 1, p = 0.22 and χ(2) = 0.9, df = 1, p = 0.34, respectively). Development of problem-solving skills did not mediate treatment outcomes. There was no significant increase in depression between the end of interventions and 12 weeks later (0.7 HAM-D point increase) (t = 1.36, df = 719, p = 0.17).
conclusionOrganizations offering CM are available across the nation. With training in CM, their social workers can serve the many depressed, disabled, low-income patients, most of whom have poor response to antidepressants even when combined with psychotherapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.