OBJECTIVE:Personalized Intervention for Depressed Patients with COPD (PID-C), a treatment mobilizing patients to participate in their care, was found more effective than usual care. To further improve its efficacy, we developed a Problem Solving-Adherence (PSA) intervention integrating problem solving into adherence enhancement procedures. We tested the hypothesis that PSA is more effective than PID-C in reducing depressive symptoms. Exploratory analyses sought to identify patients with distinct depressive symptom trajectories and compare their clinical profiles. DESIGN: Randomized controlled trial. SETTING: Acute inpatient rehabilitation and community. PARTICIPANTS: A total of 101 diagnosed with chronic obstructive pulmonary disease (COPD) and major depression after screening 633 consecutive admissions for acute inpatient rehabilitation. INTERVENTION: Fourteen sessions of PID-C versus PSA over 26 weeks. MEASUREMENTS: 24-item Hamilton Depression Rating Scale. RESULTS: PSA was not more efficacious than PID-C in reducing depressive symptoms. Exploratory latent class growth modeling identified two distinct depressive symptoms trajectories. Unlike patients with unfavorable course (28%) who remained symptomatic, patients with favorable course (72%) had a decline of symptoms during the hospitalization followed by a milder decline after discharge. Patients with unfavorable course were younger and had greater scores in disability, anxiety, neuroticism, and dyspnea related limitation in activities and lower self-efficacy scores. CONCLUSIONS: Both interventions led to sustained improvement depressive symptoms. PID-C matches the skills of clinicians employed by community rehabilitation programs and can be integrated in the care of depressed COPD patients. Patients with severe disability, anxiety, neuroticism, and low self-efficacy are at risk for poor outcomes and in need of close follow-up and targeted interventions. .
RCT Entities:
OBJECTIVE: Personalized Intervention for DepressedPatients with COPD (PID-C), a treatment mobilizing patients to participate in their care, was found more effective than usual care. To further improve its efficacy, we developed a Problem Solving-Adherence (PSA) intervention integrating problem solving into adherence enhancement procedures. We tested the hypothesis that PSA is more effective than PID-C in reducing depressive symptoms. Exploratory analyses sought to identify patients with distinct depressive symptom trajectories and compare their clinical profiles. DESIGN: Randomized controlled trial. SETTING: Acute inpatient rehabilitation and community. PARTICIPANTS: A total of 101 diagnosed with chronic obstructive pulmonary disease (COPD) and major depression after screening 633 consecutive admissions for acute inpatient rehabilitation. INTERVENTION: Fourteen sessions of PID-C versus PSA over 26 weeks. MEASUREMENTS: 24-item Hamilton Depression Rating Scale. RESULTS: PSA was not more efficacious than PID-C in reducing depressive symptoms. Exploratory latent class growth modeling identified two distinct depressive symptoms trajectories. Unlike patients with unfavorable course (28%) who remained symptomatic, patients with favorable course (72%) had a decline of symptoms during the hospitalization followed by a milder decline after discharge. Patients with unfavorable course were younger and had greater scores in disability, anxiety, neuroticism, and dyspnea related limitation in activities and lower self-efficacy scores. CONCLUSIONS: Both interventions led to sustained improvement depressive symptoms. PID-C matches the skills of clinicians employed by community rehabilitation programs and can be integrated in the care of depressed COPDpatients. Patients with severe disability, anxiety, neuroticism, and low self-efficacy are at risk for poor outcomes and in need of close follow-up and targeted interventions. .
Authors: George S Alexopoulos; Dimitris N Kiosses; Jo Anne Sirey; Dora Kanellopoulos; Joanna K Seirup; Richard S Novitch; Samiran Ghosh; Samprit Banerjee; Patrick J Raue Journal: Am J Geriatr Psychiatry Date: 2013-08-14 Impact factor: 4.105
Authors: George S Alexopoulos; Patrick J Raue; Dimitris N Kiosses; R Scott Mackin; Dora Kanellopoulos; Charles McCulloch; Patricia A Areán Journal: Arch Gen Psychiatry Date: 2011-01
Authors: George S Alexopoulos; Dimitris N Kiosses; Jo Anne Sirey; Dora Kanellopoulos; Richard S Novitch; Samiran Ghosh; Joanna K Seirup; Patrick J Raue Journal: Br J Psychiatry Date: 2013-02-07 Impact factor: 9.319
Authors: Jacob N de Voogd; Johan B Wempe; Gerard H Koëter; Klaas Postema; Eric van Sonderen; Adelita V Ranchor; James C Coyne; Robbert Sanderman Journal: Chest Date: 2008-11-24 Impact factor: 9.410
Authors: Danielle S Jackson; Samprit Banerjee; Jo Anne Sirey; Cristina Pollari; Nili Solomonov; Richard Novitch; Alexandra Chalfin; Yiyuan Wu; George S Alexopoulos Journal: Am J Geriatr Psychiatry Date: 2018-12-07 Impact factor: 4.105
Authors: George S Alexopoulos; Jo Anne Sirey; Samprit Banerjee; Danielle S Jackson; Dimitris N Kiosses; Cristina Pollari; Richard S Novitch; Amanda Artis; Patrick J Raue Journal: Am J Geriatr Psychiatry Date: 2017-10-10 Impact factor: 4.105
Authors: Jo Anne Sirey; Patrick J Raue; Nili Solomonov; Clara Scher; Alexandra Chalfin; Paula Zanotti; Jacquelin Berman; George S Alexopoulos Journal: Transl Behav Med Date: 2020-08-07 Impact factor: 3.046
Authors: Muhammad Omair Husain; Imran B Chaudhry; Amy Blakemore; Suleman Shakoor; Muhammad Ali Husain; Steven Lane; Tayyeba Kiran; Farhat Jafri; Rakhshi Memon; Maria Panagioti; Nusrat Husain Journal: SAGE Open Med Date: 2021-10-07