DEPRESSION IN YOUNG AND OLD ADULTS: THE RELATIVE EFFICACY OF COGNITIVE VERSUS BEHAVIORAL GROUP THERAPY INTERVENTIONS.

摘要

This study compared three types of group therapy in the treatment of younger (18 to 45 year old) and older (60-plus year old) psychiatric inpatient depressives. All patient participants met the diagnostic criterion for either Major Depression, or Schizoaffective Disorder, Depressed Type, using the Schedule for Affective Disorders and Schizophrenia, and the Research Diagnostic Criteria. Sixty-four participants were matched for age category and diagnosis, and randomly assigned to either Cognitive, Behavioral, or Socialization (control) group therapy. Patients were seen in small groups (i.e., 5 to 8 patients per group). All therapy groups met for twelve biweekly sessions, over the course of six weeks.;Three measures: the Schedule for Affective Disorders and Schizophrenia (SADS) and the SADS-Change Form, the Zung Depression Scale, and the Global Assessment Scale, were used to evaluate the impact of the three treatments upon depressive symptomatology.;The first hypothesis under investigation predicted that there would be more cognitive symptoms of depression among the younger patients, and more somatic symptoms of depression among the older patients. Significant age group effects were found in the predicted directions for poor appetite, negative evaluation, functional impairment, and Global Assessment Scale scores, and trends were found in the predicted directions for insomnia and psychomotor retardation. An effect in the opposite direction of that predicted was found for agitation, with a trend in the opposite direction of that predicted found for anger. Therefore, the first hypothesis was only partially supported.;The second hypothesis of this study predicted that, based on the predicted symptom differences associated with age group, younger patients would benefit more from the Cognitive group therapy, and older patients would benefit more from the Behavior group therapy. No significant interaction effects of trials by type of therapy group were obtained, however, despite significant improvement in all groups combined over the six-week period on 7 of 18 variables assessed. Significant deterioration was also found, for 2 of the 18 variables assessed in all groups combined. Therapist experience in the control vs. experimental modalities, therapist training, "caring attention" provided in all modalities, and effects of rater bias are discussed as factors accounting for these results.