Skip to main content
SpringerLink
Log in

Residual Geriatric Depression Symptoms: A Place for Psychotherapy

  • Published:
Journal of Clinical Geropsychology

Abstract

Geriatric depression is a relatively commonly occurring mental disorder. A subpopulation of depressed older adults are those who have engaged in or completed pharmacotherapy, yet continue to experience depressive symptoms. We review the prevalence, psychosocial effects, and treatment of residual symptoms of depression in older adults. Data from previous studies conducted by our group are presented to support our contention that residual symptoms of geriatric depression are treatable through psychosocial means.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Abramson, L. Y., Metalsky, G. I., and Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychol. Rev. 96: 358–372.

    Google Scholar 

  • Ackerson, J., Scogin, F., McKendree-Smith, N., and Lyman, R. D. (1998). Cognitive bibliotherapy for adolescent depression. J. Consult. Clin. Psychol. 66: 685–690.

    Google Scholar 

  • American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn., American Psychiatric Association, Washington, DC.

    Google Scholar 

  • Anderson, B. L., Kiecolt-Glaser, J. K., and Glaser, R. (1994). A biobehavioral model of cancer stress and disease course. Am. Psychol. 49: 389–404.

    Google Scholar 

  • Arean, P. A., Perri, M. G., Nezu, A. M., Schein, R. L., Christopher, F., and Joseph, T. X. (1993). Comparative effectiveness of social problem-solving therapy and reminiscence therapy as treatments for depression in older adults. J. Consult. Clin. Psychol. 61: 1003–10010.

    Google Scholar 

  • Bazargan, M., and Barbre, A. R. (1994). The effects of depression, health status, and stressful life-events on self-reported memory problems among aged blacks. Int. J. Aging Hum. Dev. 38: 351–362.

    Google Scholar 

  • Beck, A. T., Rush, J., Shaw, B., and Emery, G. (1979). Cognitive Therapy of Depression, Guilford, New York.

    Google Scholar 

  • Blackburn, I. M., Bishop, S., Glen, A. I., Whalley, L. J., and Christie, J. E. (1981). The efficacy of cognitive therapy in depression: A treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. Br. J. Psychiatry 139: 181–189.

    Google Scholar 

  • Broadhead, W. E., Blazer, D. G., George, L. K., and Tse, C. K. (1990). Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 264: 2524–2528.

    Google Scholar 

  • Callahan, C. M., Hui, S. L., Nienaber, N. A., Musick, B. S., and Tierney, W. M. (1994). Longitudinal study of depression and health services use among elderly primary care patients. J. Am. Geriatr. Soc. 42: 833–838.

    Google Scholar 

  • Cohn, C. K., Shrivastava, R., Mendels, J., Cohn, J. B., Fabre, L. F., Claghorn, J. L., Dessain, E. C., Itil, T. M., and Lautin, A. (1990). Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients. J. Clin. Psychiatry 51B: 28–33.

    Google Scholar 

  • Cole, A. J., Brittlebank, A. D., and Scott, J. (1994). The role of cognitive therapy in refractory depression. In Nolen, W. A., Zohar, J., Roose, S. P., and Amsterdam, J. D. (eds.), Refractory Depression: Current Strategies and Future Directions, Wiley, New York.

    Google Scholar 

  • De Jong, R., Treiber, R., and Henrich, G. (1986). Effectiveness of two psychological treatments for inpatients with severe and chronic depressions. Cognit. Ther. Res. 10: 645–663.

    Google Scholar 

  • Dew, M. A., and Bromet, E. J. (1991). Effects of depression on social support in a community sample of women. In Eckenrode, J. (ed.), The Social Context of Coping, Plenum Press, New York, pp. 189–211.

    Google Scholar 

  • Dobson, K. S. (1989). Ameta-analysis of the efficacy of cognitive therapy for depression. J. Consult. Clin. Psychol. 57: 414–419.

    Google Scholar 

  • Dworkin, R. H., Hartstein, G., Rosner, H. L., Walther, R. R., Sweeney, E. W., and Brand, L. (1992). A high-risk method for studying psychosocial antecedents of chronic-pain: The prospective investigation of herpes zoster. J. Abnorm. Psychol. 101: 200–205.

    Google Scholar 

  • Fava, M., and Davidson, K. G. (1996). Definition and epidemiology of treatment resistant depression. Psychiatr. Clin. North Am. 19: 179–200.

    Google Scholar 

  • Fava, G. A., Grandi, S., Zielezny, M., Canestrari, R., and Morphy, M. A. (1994). Cognitive behavioral treatment of residual symptoms in primary major depressive disorder. Am. J. Psychiatry 151: 1295–1299.

    Google Scholar 

  • Fava, G. A., Grandi, S., Zielezny, M., Rafanelli, C., and Canestrari R. (1996). Four-year outcome for cognitive behavioral treatment of residual symptoms in major depression. Am. J. Psychiatry 153: 945–947.

    Google Scholar 

  • Fava, G. A., Rafanelli, C., Grandi, S., Conti, S., and Belluardo, P. (1998). Prevention of recurrent depression with cognitive behavioral therapy: Preliminary findings. Arch. Gen. Psychiatry 55: 816–820.

    Google Scholar 

  • Fava, G. A., Savron, G., Grandi, S., and Rafanelli, C. (1997). Cognitive-behavioral management of drug-resistant major depressive disorder. J. Clin. Psychiatry 58: 278–282.

    Google Scholar 

  • Flint, A. J., and Rifat, S. L. (1996). The effect of sequential antidepressant treatment on geriatric depression. J. Affective Disord. 36: 95–105.

    Google Scholar 

  • Floyd, M., and Scogin, F. (1998). Cognitive-behavior therapy for older adults: How does it work? Psychotherapy 35: 459–463.

    Google Scholar 

  • Floyd, M., Scogin, F., McKendree-Smith, N., Floyd, D., and Rokke, P. (submitted). Cognitive therapy for depression: A comparison of individual psychotherapy and bibliotherapy for depressed older adults.

  • Friedhoff, A. J. (1994). Consensus panel report. In Schneider, L. S., Reynolds, C. F., Lebowitz, B. D., and Friedhoff, A. J. (eds.), Diagnosis and Treatment of Depression in Late Life: Results of the NIH Consensus Development Conference, American Psychiatric Press, Washington, DC.

    Google Scholar 

  • Frisch, M. B. (1998). Quality of life therapy and assessment in health care. Clin. Psychol. Sci. Pract. 5: 19–40.

    Google Scholar 

  • Gallagher, D., and Thompson, L.W. (1981). Depression in the Elderly: A Behavioral Treatment Manual, University of Southern California Press, Los Angeles.

    Google Scholar 

  • Gallagher-Thompson, D., and Thompson, L. W. (1995). Psychotherapy with older adults in theory and practice. In Bonger, B., and Beutler, L. (eds.), Comprehensive Textbook of Psychotherapy Oxford University Press, New York, pp. 357–379.

    Google Scholar 

  • Gallagher-Thompson, D., and Thompson, L.W. (1996). Applying cognitive-behavioral therapy to the psychological problems of later life. In Zarit, S. H., and Knight, B. G. (eds.), A Guide to Psychotherapy and Aging. American Psychological Association, Washington, DC.

    Google Scholar 

  • Ganguli, M., Gilby, J., and Seeberg, E. (1995). Depressive symptoms and associated factors in a rural elderly population: The MoVIES project. Am. J. Geriat. Psychiatry 3: 144–160.

    Google Scholar 

  • George, L. K. (1992). Community and home care for mentally ill older adults. In Birren, J., Sloane, R. B., and Cohen, G. D. (eds.), Handbook of Mental Health and Aging, 2nd edn., Academic Press, San Diego.

    Google Scholar 

  • Hamilton, M. (1967). Development of a rating scale for primary depressive illness. Br. J. Soc. Clin. Psychol. 57: 536–544.

    Google Scholar 

  • Hollon, S. D., Shelton, R. C., and Loosen, P. T. (1991). Cognitive therapy and pharmacotherapy for depression. J. Consult. Clin. Psychol. 59: 88–99.

    Google Scholar 

  • Hooley, J. M., Orley, J., and Teasdale, J. D. (1986). Levels of expressed emotion and relapse in depressed patients. Br. J. Psychiatry 148: 642–647.

    Google Scholar 

  • Ilardi, S., and Craighead, W. (1994). The role of nonspecific factors in cognitive-behavior therapy for depression. Clin. Psychol. Sci. Pract. 1: 138–156.

    Google Scholar 

  • Jacobson, N., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., and Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. J. Consult. Clin. Psychol. 64: 295–304.

    Google Scholar 

  • Jamison, C., and Scogin, F. (1995). The outcome of cognitive bibliotherapy with depressed adults. J. Consult. Clin. Psychol. 63: 644–650.

    Google Scholar 

  • Johnson, J., Weissman, M. M., and Klerman, G. L. (1992). Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 267: 1478–1483.

    Google Scholar 

  • Lewinsohn, P. M., Biglan, T., and Zeiss, A. (1976). Behavioral treatment of depression. In Davidson, P. (ed.), Behavioral Management of Anxiety, Depression, and Pain, Brunner/Mazel, New York, pp. 91–146.

    Google Scholar 

  • Lewinsohn, P., Munoz, R., Youngren, M. A., and Zeiss, A. (1986). Control Your Depression, Prentice-Hall, Englewood Cliffs, NJ.

    Google Scholar 

  • Mahapatra, S. N., and Hackett, D. (1997). A randomized, double-blind, parallel-group comparison of venlafaxine and dothiepin in geriatric patients with major depression. Int. J. Clin. Pract. 51: 209–213.

    Google Scholar 

  • McCullough, J. B., and Lynch, M. S. (1993). Barriers to solutions: Service delivery and public policy in rural areas. J. Appl. Gerontol. 12: 388–403.

    Google Scholar 

  • McFarland, B. H., Freeborn, D. K., Mullooly, J. P., and Pope, C. R. (1985). Utilization patterns among long-term enrollees in a prepaid group practice health maintenance organization. Med. Care 23: 1221–1233.

    Google Scholar 

  • Miller, I. W., Bishop, S. B., Normal, W. H., and Keitner, G. I. (1985). Cognitive/behavioural therapy and pharmacotherapy with chronic, drug-refractory depressed inpatients: A note of optimism. Behav. Psychother. 13: 320–327.

    Google Scholar 

  • Olfson, M., and Klerman, G. L. (1987). The treatment of depression: Prescribing practices of primary care physicians and psychiatrists. J. Family Pract. 34: 627–635.

    Google Scholar 

  • Paykel, E. S., Scott, J., Teasdale, J. D., Johnson, A. L., Garland, A., Moore, R., Jenaway, A., Cornwall, P. L., Hayhurst, H., Abbott, R., and Pope, M. (1999). Prevention of relapse in residual depression by cognitive therapy: A controlled trial. Arch. Gen. Psychiatry 56: 829–835.

    Google Scholar 

  • Reynolds, C. F., Frank, E., Perel, J. M., Imber, S. D., Cornes, C., Miller, M. D., Mazumdar, S., Houck, P. R., Dew, M. A., Stack, J. A., Pollock, B. G., and Kupfer, D. J. (1999). Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: A randomized controlled trial in patients older than 59 years. JAMA 281: 39–45.

    Google Scholar 

  • Robinson, P. (1996). Living Life Well: New Strategies for Hard Times, Context Press, Reno, NV.

    Google Scholar 

  • Robinson, P. (1998). Behavioral health services in primary care: A new perspective for treating depression. Clin. Psychol. Sci. Pract. 5: 77–89.

    Google Scholar 

  • Robinson, L. A., Berman, J. S., and Neimeyer, R. A. (1990). Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research. Psychol. Bull. 108(1): 30–49.

    Google Scholar 

  • Rowan, P. J., Davidson, K., Campbell, J., and MacLean, D. R. (1999). Depression and medical care utilization: Stronger relation for older adults. Paper presented at the National Conference on Health Statistics, Washington, DC, August, 1999.

  • Scheidt, R. J. (1985). The mental health of the aged in rural environments. In Cowart, R. T., and Lee, G. R. (eds.), The Elderly in Rural Society, Springer, New York.

    Google Scholar 

  • Schmidt, M. M., and Miller, W. R. (1983). Amount of therapist contact and outcome in a multidimensional depression treatment program. Acta Psychiatr. Scand. 67: 319–332.

    Google Scholar 

  • Scogin F., Jamison, C., and Gochneaur, K. (1989). Cognitive and behavioral bibliotherapy for mildly and moderately depressed older adults. J. Consult. Clin. Psychol. 57: 403–407.

    Google Scholar 

  • Scogin, F., and McElreath, L. (1994). Efficacy of psychosocial treatments for geriatric depression: A quantitative review. J. Consult. Clin. Psychol. 62: 69–74.

    Google Scholar 

  • Shapiro, D. A. (1981). Comparative credibility of treatment rationales: Three tests of expectancy theory. Br. J. Clin. Psychol. 20: 111–122.

    Google Scholar 

  • Sharan, P., and Saxena, S. (1998). Treatment-resistant depression: Clinical significance, concept and management. Natl. Med. J. India 11: 69–79.

    Google Scholar 

  • Simon, G., Ormel, J., VonKorff, M., and Barlow, W. (1995). Health care costs associated with depressive and anxiety disorders in primary care. Am. J. Psychiatry 152: 352–357.

    Google Scholar 

  • Smith, M., and Buckwalter, D. C. (1993). Mental health care for rural seniors. Health Prog. 74: 52–70.

    Google Scholar 

  • Stoudemire, A., Hill, C. D., Morris, R., and Dalton, S. T. (1995). Improvement in depression-related cognitive dysfunction following ECT. J. Neuropsychiatry Clin. Neurosci. 7: 31–34

    Google Scholar 

  • Teri, L., Logsdon, R. G., Uomoto, J., and McCurry, S. M. (1997). Behavioral treatment of depression in dementia patients: A controlled clinical trial. J. Gerontol. B Psychol. Sci. Soc. Sci. 52B: 159–166.

    Google Scholar 

  • Thase, M. E. (1997). Psychotherapy of refractory depressions. Depr. Anxiety 5: 190–201.

    Google Scholar 

  • Thase, M. E., and Howland, R. (1994). Refractory depression: Relevance of psychosocial factors and therapies. Psychiatr Ann. 24: 232–240.

    Google Scholar 

  • Thase, M. E., Howland, R. H., and Friedman, E. S. (1998). Treating antidepressant nonresponders with augmentation strategies: An overview. J. Clin. Psychiatry 59(Suppl. 5): 5–15.

    Google Scholar 

  • Thase, M. E., and Rush, J. A. (1995). Treatment-resistant depression. In Bloom, F. E., and Kupfer, D. J. (eds.), Psychopharmacology: The Fourth Generation of Progress, Raven Press, New York. pp. 1081–1097.

    Google Scholar 

  • Thase, M. E., and Rush, A. J. (1997). When at first you don't succeed: sequential strategies for antidepressant nonresponders. J. Clin. Psychiatry 58(Suppl. 13): 23–29.

    Google Scholar 

  • Thompson, L. W., Coon, D. W., Gallagher-Thompson, D., Sommer, B., and Koin, D. (in press). Comparison of desipramine and cognitive/behavioral therapy in the treatment of elderly outpatients with mild to moderate depression. Am. J. Geriat. Psychiatry

  • Thompson, L. W., Gallagher, D., and Breckenridge, J. S. (1987). Comparative effectiveness of psychotherapies for depressed elders. J. Consult. Clin. Psychol. 55: 385–390.

    Google Scholar 

  • Tollefson, G. D., Bosomworth, J. C., Heiligenstein, J. H., Potvin, J. H., and Holman, S. (1995). A double-blind, placebo-controlled clinical trial of fluoxetine in geriatric patients with major depression: The fluoxetine collaborative study group. Int. Psychogeriat. 7: 89–104.

    Google Scholar 

  • Tweed, D. (1993). Depression-related impairment: Estimating concurrent and lingering effects. Psychol. Med. 23: 373–386.

    Google Scholar 

  • Unützer, J., Patrick, D. L., Simon, G., Grembowski, D., Walker, E., Rutter, C., and Katon, W. (1997). Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: A 4-year prospective study. J. Am. Med. Assoc. 277: 1618–1623.

    Google Scholar 

  • Vitaliano, P. P., Dougherty, C. M., and Siegler, I. C. (1994). Biopsychosocial risks for cardiovascular disease. In Abeles, R. P., Gift, H. C., and Ory, M. G. (eds.), Aging and Quality of Life, Springer, New York.

    Google Scholar 

  • Wells, K. B., Steward, A., Hays, R. D., Burnam, A., Rogers, W., Daniels, M., Berry, S., Greenfield, S., and Ware, J. (1989). The functioning and well-being of depressed patients: Results from the Medical Outcomes Study. J. Am. Med. Assoc. 262: 914–919.

    Google Scholar 

  • Wilson, K. C. M., Scott, M., Abou-Saleh, M., Burns, R., and Copeland, J. R. M. (1995). Long-term effects of cognitive-behavioural therapy and lithium therapy on depression in the elderly. Br. J. Psychiatry 167: 653–658.

    Google Scholar 

  • Wollersheim, J., and Wilson, G. (1990). Group treatment of unipolar depression: A comparison of coping, supportive, and delayed treatment groups. Prof. Psychol. Res. Pract. 22: 496–502.

    Google Scholar 

  • Zarit, S. H., Gallagher, D., and Kramer, N. (1981). Memory training in the community aged: Effects of depression, memory complaint, and memory performance. Educ. Gerontol. 6: 11–27.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Alabama, Tuscaloosa, Alabama

    Forrest Scogin, Jodie Shackelford, Noelle Rohen & Jamie Stump

  2. Department of Psychology, University of Nevada at Las Vegas, Las Vegas, Nevada

    Mark Floyd

  3. Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama

    Nancy McKendree-Smith

  4. Tuskegee Veterans Administration Hospital, USA

    Christine Jamison

Authors
  1. Forrest Scogin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jodie Shackelford
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Noelle Rohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jamie Stump
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark Floyd
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nancy McKendree-Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Christine Jamison
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scogin, F., Shackelford, J., Rohen, N. et al. Residual Geriatric Depression Symptoms: A Place for Psychotherapy. Journal of Clinical Geropsychology 7, 271–283 (2001). https://doi.org/10.1023/A:1011396108627

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011396108627

Search

Navigation