A brief problem-solving indicated-prevention intervention for prevention of depression in nonprofessional caregivers

  1. Vázquez González, Fernando Lino
  2. Otero Otero, Patricia
  3. Torres Iglesias, Ángela
  4. Hermida, Elisabet
  5. Blanco Seoane, Vanessa
  6. Díaz Fernández, Olga
Journal:
Psicothema

ISSN: 0214-9915

Year of publication: 2013

Volume: 25

Issue: 1

Pages: 87-92

Type: Article

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Abstract

Antecedentes: a pesar que la depresión es un problema frecuente en los cuidadores no profesionales, en la literatura no hay estudios de prevención indicada de la depresión en esta población. Se evaluó la eficacia de una intervención de solución de problemas para prevenir la depresión clínica en una muestra de cuidadoras. Método: se realizó un ensayo controlado aleatorizado entre 173 participantes (edad promedio 53,9 años), 89 de las cuales fueron asignadas al azar al grupo de intervención y 84 (controles) a atención habitual. La intervención constó de cinco sesiones aplicadas semanalmente en formato grupal de una duración de 90 minutos cada una. Resultados: en el postratamiento, los síntomas depresivos en el grupo de intervención disminuyeron significativamente más que en el grupo control, con un tamaño del efecto d grande de 1,54. La proporción de participantes con mejoría clínicamente significativa fue significativamente mayor en el grupo de intervención (80,9% frente a 11,9% entre los controles); y menos participantes del grupo de intervención progresaron a una depresión clínica durante el período del estudio (4,5% frente a 13,1% entre los controles). El grupo de intervención también tuvo una reducción significativamente mayor en malestar emocional y sobrecarga del cuidador que el grupo control. Conclusiones: estos hallazgos demuestran la eficacia de la intervención a corto plazo.

Bibliographic References

  • Allart-van Dam, E., Hosman, C.M., Hoogduin, C.A., & Schaap, C.P. (2003). The Coping with Depression Course: Short-term outcomes and mediating effects of a randomized controlled trial in the treatment of subclinical depression. Behavior Therapy, 34, 381-396 doi: 10.1016/ S0005-7894(03)80007-2.
  • Allart-van Dam, E., Hosman, C.M., Hoogduin, C.A., & Schaap, C.P. (2007). Prevention of depression in subclinically depressed adults: Follow-up effects on the "Coping with Depression" course. Journal of Affective Disorders, 97, 219-228 doi:10.1016/j.jad.2006.06.020.
  • Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale, New Jersey: Lawrence Erlbaum Associates.
  • Crespo, M., & López, J. (2007). El estrés en cuidadores de mayors dependientes. Cuidarse para cuidar [Stress in caregivers of dependent elderly people. Care to take care of]. Madrid: Pirámide.
  • Cuijpers, P., & Smit, F. (2004). Subthreshold depression as a risk indicator for major depressive disorder: A systematic review of prospective studies. Acta Psychiatrica Scandinavica, 109, 325-331 doi:10.1111/ j.1600-0447.2004.00301.x.
  • Cuijpers, P., van Straten, A., Smit, F., Mihalopoulos, C., & Beekman, A. (2008). Preventing the onset of depressive disorders: A meta-analytic review of psychological interventions. American Journal of Psychiatry, 165, 1272-1280 doi:10.1176/appi.ajp.2008.07091422.
  • First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1999). Entrevista Clínica Estructurada para los Trastornos del Eje I del DSM-IV-Versión Clínica (SCID-CV) [Structured Clinical Interview for DSMIV Axis I Disorders, Clinician Version (SCID-CV)]. Barcelona: Masson.
  • Gallagher-Thompson, D., & Coon, D.W. (2007). Evidence-based psychological treatments for distress in family caregivers of older adults. Psychology and Aging, 22, 37-51 doi:10.1037/0882-7974.22.1.37.
  • Gallagher-Thompson, D., Rose, J., Rivera, P., Lovett, S., & Thompson, L.W. (1989). Prevalence of depression in family caregivers. Gerontologist, 29, 449-456 doi: 10.1093/geront/29.4.449.
  • Godoy-Izquierdo, D., Godoy, J.F., López-Torrecillas, F., & Sánchez-Barrera, M.B. (2002). Propiedades psicométricas de la versión española del "Cuestionario de Salud General de Goldberg-28" [Psychometric properties of the Spanish version of the "General Health Questionnaire-28"]. Revista de Psicología de la Salud, 14, 49-71.
  • González, S., Fernández, C., Pérez, J., & Amigo, I. (2006). Depression secondary prevention in primary care. Psicothema, 18, 471-477.
  • Guillemin, F., Bombardier, C., & Beaton, D. (1993). Cross-cultural adaptation of health related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 43, 1417-1432 doi:10.1016/0895-4356(93)90142-N.
  • Guyatt, G.H., Sackett, D.L., & Cook, D.J. (1994). User's guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? The Journal of American Medical Association, 271, 59-63 doi:10.1001/jama.1994.03510250075039.
  • Instituto de Mayores y Servicios Sociales [IMSERSO] (2005). Cuidados a las personas mayores en los hogares españoles. El entorno familiar [Care for the elderly in Spanish households. The family environment]. Madrid: Ministerio de Trabajo y Asuntos Sociales.
  • Konnert, C., Dobson, K., & Stelmach, L. (2009). The prevention of depression in nursing home residents: A randomized clinical trial of cognitive-behavioral therapy. Aging and Mental Health, 13, 288-299 doi: 10.1080/13607860802380672.
  • Kuehner, C. (2003). Gender differences in unipolar depression: An update of epidemiological findings and possible explanations. Acta Psychiatrica Scandinavica, 108, 163-174 doi:10.1034/j.1600-0447.2003.00204.x.
  • Lobo, A., Pérez-Echeverría, M.J., & Artal, J. (1986). Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychological Medicine, 16, 135-140 doi:10.1017/S0033291700002579.
  • Marchand, E., Stice, E., Rohde, P., & Becker, C.B. (2011). Moving from efficacy to effectiveness trials in prevention research. Behaviour Research and Therapy, 49, 32-41 doi:10.1016/j.brat.2010.10.008.
  • Muñoz, R.F., Le, H.N., Clarke, G., & Jaycox, L. (2002). Preventing the onset of major depression. In I.H. Gotliby & C.L. Hammen (Eds.), Handbook of depression (pp. 343-359). New York: Guilford.
  • Nezu, A.M., Nezu, C.M., & Perri, M.G. (1989). Problem-solving therapy for depression. Theory, research, and clinical guidelines. New York: John Wiley & Sons.
  • Papastavrou, E., Kalokerinou, A., Papacostas, S.S., Tsangari, H., & Sourtzi, P. (2007). Caring for a relative with dementia: Family caregiver burden. Journal of Advanced Nursing, 58, 446-457 doi:10.1111/j.1365-2648.2007.04250.x.
  • Pinquart, M., & Sörensen, S. (2006). Helping caregivers of persons with dementia: Which interventions work and how large are their effects? International Psychogeriatrics, 18, 577-595 doi:10.1017/ S1041610206003462.
  • Redinbaugh, E.M., MacCallum, R.C., & Kiecolt-Glaser, J.K. (1995). Recurrent syndromal depression in caregivers. Psychology and Aging, 10, 358-368 doi: 10.1037/0882-7974.10.3.358.
  • Schulz, R., O'Brien, A.T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes. Gerontologist, 35, 771-791 doi:10.1093/ geront/35.6.771
  • Sörensen, S., Pinquart, M., & Duberstein, P. (2002). How effective are interventions with caregivers? An updated meta-analysis. Gerontologist, 42, 356-372 doi:10.1093/geront/42.3.356.
  • Van't Veer-Tazelaar, N., Van Marwijk, H., Van Oppen, P., Van der Horst, H.E., Smit, F., Cuijpers, P., Beekman, A.T. (2011). Prevention of late-life anxiety and depression has sustained effects over 24 months: A pragmatic randomized trial. American Journal of Geriatric Psychiatry, 19, 230-239 doi: 10.1097/JGP.0b013e3181faee4d.
  • Van't Veer-Tazelaar, N., Van Marwijk, H., Van Oppen, P., Van Hout, H., Van der Horst, H.E., Cuijpers, P., Beekman, A.T. (2009). Stepped-care prevention of anxiety and depression in late life. Archives of General Psychiatry, 66, 297-304 doi: 10.1001/archgenpsychiatry.2008.555
  • Vázquez, F.L., Blanco, V., & López, M. (2007). An adaptation of the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations. Psychiatry Research, 149, 247-252 doi:10.1016/j. psychres.20 06.03.004.
  • Vázquez, F.L., & Otero, P. (2009). The efficacy of psychological interventions in reducing depressive symptoms in dementia caregivers: A review. Behavioral Psychology/Psicología Conductual, 17, 573-593.
  • Vázquez, F.L., Otero, P., López, M., Blanco, V., & Torres, A. (2010). A short problem-solving based course for prevention of depression in non-professional providers of care for dementia patients: A pilot study. Clinical and Health, 21, 59-76 doi:10.5093/cl2010v21n1a6.
  • Vickers, A.J. (2005). Analysis of variance in easily misapplied in the analysis of randomized trials: A critique and discussion of alternative statistical approaches. Psychosomatic Medicine, 67, 652-655 doi:10.1097/01. psy0000172624.52957.a8
  • Willemse, G.R.W.M., Smit, F., Cuijpers, P., & Tiemens, B.G. (2004). Minimal-contact psychotherapy for sub-threshold depression in primary care. British Journal of Psychiatry, 185, 416-421 doi:10.1192/ bjp.185.5.416.
  • Williamson, G.M., & Shafer, D.R. (2001). Relationship quality and potentially harmful behaviors by spousal caregivers: How we were then, how we are now. Psychology and Aging, 16, 217-226 doi:10.1037/0882-7974.16.2.217.
  • Zarit, S.H., Reever, K.E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist, 20, 649-655 doi:10.1093/geront/20.6.649.
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