Examining the feasibility and effectiveness of case manager delivered problem-solving therapy on late-life depression in a real-world setting: a mixed design pilot study

Figures & data

Table 1. Demographic and baseline clinical characteristics

n = 29
Demographic characteristics
Age (years), mean (SD), range	72.5 (5.2), 63–84
BMI (kg/m^2), mean (SD), range	30.15 (6.2), 24.1–41.8
Female, n (%)	18 (62.1)
Ethnicity, n (%)
Caucasian	27 (93.1)
Mixed	1 (3.4)
East Indian	1 (3.4)
Married or common-law, n (%)	13 (44.8)
Divorced, widowed, or single, n (%)	16 (55.2)
Education Completed elementary school only, n (%)	6 (20.7)
Completed elementary and high school, n (%)	5 (17.2)
Completed post-secondary education, n (%)	18 (62)
Retired, n (%)	25 (86.2)
Consumes tobacco, n (%)	1 (3.4)
Drinks alcohol >1 per week, n (%)	5 (17.2)
Clinical characteristics
Presence of early onset of depression (before age 60), n (%)	25 (86.2)
Number of self-reported episodes of depression, n (%)
Single episode	12 (41.4)
2 to 3	8 (27.6)
4 to 10	3 (10.3)
More than 10	6 (20.7)
MMSE, mean (SD), range	28.8 (1.4), 25–30
CIRS-G, mean (SD), range
Number of categories endorsed	6.5 (2.6), 1–12
Total	11.2 (4.4), 3–20
Severity	1.7 (0.4), 0.4–3
Taking two or more antidepressant medications	3 (10.3)
Using any psychotropic	22 (75.9)
Type of medication(s), n (%)
Selective serotonin reuptake inhibitors	10 (34.5)
Serotonin-norepinephrine reuptake inhibitors	5 (17.2)
Mirtazapine/bupropion	5 (17.2)
Tricyclic antidepressants	2 (6.9)
Taking antipsychotic medication(s)	7 (24.1)
Benzodiazepine	6 (20.7)
Trazadone	5 (3.4)
Anxiolytic/sedative hypnotic	4 (13.8)
Anticonvulsants	2 (6.9)
Anti-manic	1 (3.4)
Cannabinoid	1 (3.4)

SD: standard deviation, BMI: body mass index, MMSE: Mini Mental State Exam, CIRS-G: Cumulative Illness Rating Scale—Geriatric.

Figure 1. Recruitment flow diagram.

Table 2. Paired-samples t-test and the corresponding effect sizes of data comparing effects of pre- and post-Problem Solving Therapy intervention on depression and related comorbidity symptoms at baseline (week 0) and end of study (week 8) from available participant data. SD: Standard Deviation, SE: Standard Error, HDRS-17: Hamilton Depression Rating Scale, GAD-7: Generalized Anxiety Disorder, WHODAS-2: World Health Organization Disability Assessment Schedule 2, EQ-5D-5 L: EuroQol 5 Dimension 5 Level, VAS: visual analogue scale, PHQ-9: Patient Health Questionnaire

				95% Confidence Interval of the Difference
	Mean Difference	SD of the Mean	SE of the Mean	Lower	Upper	t	df	Sig. (2-tailed)	Hedge’s g
HDRS-17	−2.44	6.10	1.22	−0.08	4.96	2.001	24	0.057	0.49
GAD-7	−2.06	4.68	0.95	0.09	4.04	2.160	23	0.041	0.48
Athen’s Insomnia	−1.69	3.99	0.78	0.08	3.30	2.164	25	0.040	0.37
WHODAS-2 Total	−2.48	9.11	1.79	−1.21	6.16	1.385	25	0.178	0.19
EQ-5D-5 l EVAS	1.46	14.78	2.90	−7.43	4.51	−0.504	25	0.618	0.15
EQ-5D-5 L Index	0.01	0.14	0.03	−0.06	0.05	−0.191	25	0.850	0.05
PHQ-9	−4.41	4.97	1.04	2.27	6.56	4.263	22	0.000	0.79

Figure 2. Mean change in mood and disability symptoms ± 95% confidence interval . HDRS-17: Hamilton depression rating scale, GAD-7: generalized anxiety disorder, WHODAS-2: world health organization disability assessment.

Figure 3. Mean change in PHQ-9 ± 95% confidence intervals. PHQ-9: patient health questionnaire.

Figure 4. An integrative framework of problem-solving therapy among seniors with depression.