Sustained benefit of supportive intervention for depressive symptoms in caregivers of patients with Alzheimer's disease
Sustained benefit of supportive intervention for depressive symptoms in caregivers of patients with Alzheimer's disease
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DOI：
10.1176/appi.ajp.161.5.850
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发表时间：
2004-05-01
影响因子：
17.7
通讯作者：
Haley, WE
中科院分区：
文献类型：
--
作者：
Mittelman, MS;Roth, DL;Haley, WE
目的：探讨心理咨询和心理支持对阿尔茨海默病患者抑郁症状的长期影响。方法：研究对象为406名基线时住在家中的阿尔茨海默病患者的配偶照顾者。护理人员被随机分配到接受强化咨询和支持治疗的一组或接受常规护理的一组（对照组）。强化治疗组的护理人员接受了6次个人和家庭咨询，同意在入组4个月后加入支持小组，并接受持续的特别咨询。老年人抑郁量表在基线和定期随访间隔进行，只要照顾者参与研究。结果：在基线差异得到控制后，强化治疗组的护理人员在干预后的抑郁症状明显少于对照组。这些影响在基线后持续了3.1年，性别和患者严重程度相似，并且在养老院安置或患者死亡后持续。结论：咨询和支持在减少阿尔茨海默病患者配偶照顾者的抑郁症状方面具有持续的益处，应广泛提供，为家庭照顾者提供有效的循证干预。
Objective: The long-term effect of counseling and support on symptoms of depression was examined in spouse-caregivers of patients with Alzheimer's disease.Method: The participants were 406 spouse-caregivers of Alzheimer's disease patients who lived at home at baseline. The care-givers were randomly assigned to either a group receiving enhanced counseling and support treatment or a group receiving usual care (control group). Caregivers in the enhanced treatment group were provided with six sessions of individual and family counseling, agreed to join support groups 4 months after enrollment, and received ongoing ad hoc counseling. The Geriatric Depression Scale was administered at baseline and at regular follow-up intervals for as long as the caregiver participated in the study.Results: After baseline differences were controlled for, caregivers in the enhanced treatment group had significantly fewer depressive symptoms after the intervention than did the control subjects. These effects were sustained for 3.1 years after baseline, similar across gender and patient severity level, and sustained after nursing home placement or death of the patient.Conclusions: Counseling and support lead to sustained benefits in reducing depressive symptoms in spouse-caregivers of Alzheimer's disease patients and should be widely available to provide effective, evidence-based intervention for family caregivers.