'New' Tool May Be Effective for Depression in Older Adults

Katharine Gammon

April 02, 2013

LOS ANGELES — Geriatric psychiatrists may have a "new" tool for treating major depression in older patients — behavioral activation (BA) therapy.

A small feasibility study conducted by investigators at Northwestern University in Evanston, Illinois, showed that BA therapy resulted in a 50% reduction in depressive symptoms after 8 weeks of treatment in a group of older adult women.

"Behavioral activation focuses on 'activating' the client and increasing positive reinforcement with the expectation that improved mood will result," study investigator Sandra Swantek, MD, told Medscape Medical News.

Once activated, the client may ultimately choose to address the cognitive components of depression by engaging in a cognitively focused therapy. In addition, BA therapy has been shown to be as effective as cognitive-behavioral therapy in the treatment of depression, producing longer-lasting benefit at less cost.

The findings were presented here at the American Association for Geriatric Psychiatry (AAGP) 2013 Annual Meeting.

Although BA therapy is not new, until now, it has not been rigorously studied in older individuals, said Dr. Swantek

The study included 10 older women (average age, 71.9 years) with major depressive disorder.

Participants received weekly BA therapy for 8 weeks. Response was defined as a 50% reduction in depressive symptoms measured before and after treatment using the Clinician-Rated Inventory of Depressive Symptomatology and the Geriatric Depression Scale–Short Form.

The investigators found that at study conclusion, BA therapy resulted in a 50% reduction in symptoms, leading them to conclude that it may be "useful in the treatment of older adults with major depression." However, the researchers also note that BA therapy needs to be "streamlined" for older adults and that increased repetition of BA concepts is needed.

They added that on the basis of these findings, further investigation into the use of BA therapy in this patient population is warranted.

Commenting on the study for Medscape Medical News, Kim Bullock, MD, clinical associate professor in the Department of Psychiatry and Behavioral Sciences at Stanford University in California, believes the findings are promising.

"Simpler approaches like behavioral approaches can work so nicely with older patients," said Dr. Bullock. "Behavioral activation is more adjustable, more deliverable, and shorter. It's a 4-step procedure that can be taught to anybody."

Dr. Swantek and Dr. Bullock report no relevant financial relationships.

American Association for Geriatric Psychiatry (AAGP) 2013 Annual Meeting. Abstract NR 08. Presented March 15, 2013.