Sherry A Beaudreau1, Tiffany Rideaux2, Ruth O'Hara3, Patricia Arean4. 1. Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto VA Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA; School of Psychology, University of Queensland, Brisbane, Australia. Electronic address: sherryb@stanford.edu. 2. Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto VA Health Care System, Palo Alto, CA. 3. Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto VA Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA; School of Psychology, University of Queensland, Brisbane, Australia. 4. Department of Psychiatry, University of California, San Francisco, CA.
Abstract
OBJECTIVES: To identify cognitive predictors of geriatric depression treatment outcome. METHOD: Older participants completedbaseline measures of memory and executive function, health, and baseline and post-treatment Hamilton Depression Scales (HAM-D) in a 12-week trial comparing psychotherapies (problem-solving vs. supportive; N = 46). We examined cognitive predictors to identify treatment responders (i.e., HAM-D scores reduced by ≥50%) and remitters (i.e., post-treatment HAM-D score ≤10). RESULTS: Empirically derived decision trees identified poorer performance on switching (i.e., Trails B), with a cut-score of ≥82 predicting psychotherapy responders. No other cognitive or health variables predicted psychotherapy outcomes in the decision trees. CONCLUSIONS: Psychotherapies that support or improve the executive skill of switching may augment treatment response for older patients exhibiting executive dysfunction in depression. If replicated, Trails B has potential as a brief cognitive tool for clinical decision-making in geriatric depression. Published by Elsevier Inc.
RCT Entities:
OBJECTIVES: To identify cognitive predictors of geriatric depression treatment outcome. METHOD: Older participants completed baseline measures of memory and executive function, health, and baseline and post-treatment Hamilton Depression Scales (HAM-D) in a 12-week trial comparing psychotherapies (problem-solving vs. supportive; N = 46). We examined cognitive predictors to identify treatment responders (i.e., HAM-D scores reduced by ≥50%) and remitters (i.e., post-treatment HAM-D score ≤10). RESULTS: Empirically derived decision trees identified poorer performance on switching (i.e., Trails B), with a cut-score of ≥82 predicting psychotherapy responders. No other cognitive or health variables predicted psychotherapy outcomes in the decision trees. CONCLUSIONS: Psychotherapies that support or improve the executive skill of switching may augment treatment response for older patients exhibiting executive dysfunction in depression. If replicated, Trails B has potential as a brief cognitive tool for clinical decision-making in geriatric depression. Published by Elsevier Inc.
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