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Problem solving therapy for the depression‐executive dysfunction syndrome of late life
Author(s) -
Alexopoulos George S.,
Raue Patrick J.,
Kanellopoulos Dora,
Mackin Scott,
Arean Patricia A.
Publication year - 2008
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1988
Subject(s) - executive dysfunction , depression (economics) , executive functions , perseveration , psychology , psychiatry , pharmacotherapy , cognition , medicine , neuropsychology , economics , macroeconomics
Background The ‘depression executive dysfunction syndrome’ afflicts a considerable number of depressed elderly patients and may be resistant to conventional pharmacotherapy. Non‐pharmacological approaches addressing their behavioral deficits may reduce disability and experienced stress and improve depression. Methods This paper focuses on problem solving therapy (PST) because it targets concrete problems that can be understood by patients with executive dysfunction and trains patients to address them using an easy to comprehend structured approach. Results We suggest that PST is a suitable treatment for patients with the depression‐executive dysfunction syndrome because it has been found effective in uncomplicated geriatric major depression and in other psychiatric disorders accompanied by severe executive dysfunction. Furthermore, PST can address specific clinical features of depressed patients with executive dysfunction, especially when modified to address difficulties with affect regulation, initiation and perseveration. Conclusions A preliminary study suggests that appropriately modified PST improves problem solving skills, depression and disability in elderly patients with the depression‐executive dysfunction syndrome of late life. If these findings are confirmed, PST may become a therapeutic option for a large group of depressed elderly patients likely to be drug resistant. Copyright © 2008 John Wiley & Sons, Ltd.