Secondary prevention of depressive symptoms in elderly inhabitants of residential homes.

The effects of a multifaceted secondary prevention intervention in residential homes in the Netherlands were examined, using a quasi-experimental design. In five experimental residential homes, the caregivers received three training sessions on detecting depression and on supporting depressed residents. Furthermore, an information session was organized for all personnel, a further session was organized for residents and their relatives, and several group interventions were offered. 213 residents participated in the study. 211 residents of five other residential homes, matched on basic variables, served as a comparison group. Effects on depressive symptoms (geriatric depression scale) and health related quality of life (MOS-SF-36) were measured at pretest and after the intervention, one year later. Because the drop-out rate was high and drop-outs differed significantly from the remaining population, the scores of drop-outs were imputed. Since we used a quasi-experimental design, we controlled for confounding variables. Regression analyses resulted in significant effects of the intervention on the GDS and on role functioning in the total population. When the analyses were limited to those scoring high on the GDS at pretest, significant effects were found on the GDS, and on four domains of health-related quality of life: psychological distress, role functioning, pain and social functioning. The improvement in GDS scores in GDS cases was significantly larger than in other subjects. Our results suggest that general approaches aimed at a residential home are capable of influencing depressive symptoms in inhabitants. Possibly, it may not be necessary to wait until depressive symptoms have escalated and inhabitants need extensive treatment. Copyright 2001 John Wiley & Sons, Ltd.