A Trial on the Effectiveness of Screening and Brief Problem-Solving Therapy (PST) for Elderly Patients With Psychological Problems

Study Overview
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Brief Summary
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The aim of this study was to determine whether screening followed by brief PSC provided by primary care doctors could improve the quality of life of elderly patients with unrecognized psychological problems in primary care. The following hypotheses were tested: Elderly patients screened positive of psychological problems had poorer health-related quality of life (HRQOL) than those who were screened negative. Primary care doctors could be trained to provide brief PST. Brief PST by a trained primary care doctor could improve the HRQOL of the elderly who were screened positive for psychological problems.

Detailed Description
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Design & methods: A prospective single-blind randomised controlled trial (RCT) on 299 patients aged 60 or above without any known psychological diseases but screened positive for psychological problems by the Hospital Anxiety and Depression Scale (HADS). Subjects were randomised to problem-solving (PST) or video-viewing (placebo). All subjects continued with their usual care and were followed up by telephone at 6, 12, 26 and 52 weeks.Changes in SF-36 HRQOL scores, HADS scores and monthly consultation rates at 6, 12, 26 and 52 weeks within groups and between groups.

Official Title
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A Randomised Controlled Trail on the Effectiveness of Screening and Brief Counselling (Problem-Solving Therapy) for Elderly Patients With Psychological Problems in Primary Care.

Conditions
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Undiagnosed Psychological Problems

Intervention / Treatment
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* Behavioral: problem-solving therapy
* Behavioral: Video-viewing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 60 or above not known to have any psychological problem HADS Depression score 6 or above, or Anxiety Score 3 or above Written consent to study Exclusion Criteria: known psychological disease diagnosed by a registered doctor history of taking any psychotropic drug prescribed by a registered doctor within the last year; suicidal plan or strong suicidal thought; psychotic symptom; impairment in cognitive function; or communication problem.

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: problem-solving therapy<br>Three sessions of brief problem-solving counselling at week 1, 3 and 5 by a family doctor. | Behavioral: problem-solving therapy<br>* Three sessions of problem-solving therapy at week 1, 3 and 5.<br>|
| Placebo Comparator: viewing video<br>Three sessions of health education viewing video in groups of 3 to 5 people | Behavioral: Video-viewing<br>* Three sessions of viewing health educational videos.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health-related quality of life scores |  | 6, 12, 26 and 52 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital Anxiety & Depression Scale scores |  | 6, 12, 26 and 52 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mental health, problem-solving therapy, elderly, health-related quality of life, primary care, Chinese