None listed
Conditions
Brief summary
Symptoms of low mood and depression are common in later life and can include; feeling sad, empty or down, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, poor concentration and thoughts about death. There is now evidence that depression is 23% more frequent among people living in regional Australia than in the city, possibly because of difficulty accessing relevant health services. When feeling low, a person’s motivation to do things can decrease. Some may find that they give up hobbies or activities previously enjoyed, and over time might end up doing very little. This can lead to a further decline in mood and start a vicious cycle that can be difficult to break. One of the ways of overcoming depression and low mood is by changing behaviour, such as gradually increasing activity levels. The results of several studies show that the more activities people engage in the better they feel. Behavioural Activation (BA) interventions encourage participants to meaningfully increase their engagement in activities with the aim of improving mood and sense of achievement. The current pilot study is seeking to test out (pilot) whether a supported self-help behavioural activation intervention designed for older Western Australians living in regional and remote areas is effective at: preventing the onset of depression among those with some depressive symptoms. The results will be used to improve the program and make it ready for a full clinical trial so that definitive evidence of the effectiveness of the intervention can be obtained. Specific aim of definitive trial: To determine the effect of a BA intervention on the 1 year incidence rate of Major Depression in older adults with subsyndromal depression living in regional Western Australia.
Interventions
Self-help behavioural activation (BA) remotely supported by telephone vs usual care.
Participants randomised to BA will be mailed a specifically-designed self help workbook titled "Helping you to maintain a positive mood in older age". The workbook is based on clear principles of an evidence supported psychological treatment for depression in later life. It outlines relevant information about depression and offers guidance on how to identify depressive symptoms and take action to improve mental
Self-help behavioural activation (BA) remotely supported by telephone vs usual care. Participants randomised to BA will be mailed a specifically-designed self help workbook titled "Helping you to maintain a positive mood in older age". The workbook is based on clear principles of an evidence supported psychological treatment for depression in later life. It outlines relevant information about depression and offers guidance on how to identify depressive symptoms and take action to improve mental wellbeing. In particular, the booklet outlines how to monitor activities, keep a balance between activities and recognise the connection between activity and mood. To offer support to participants and optimise adherence to the intervention, a behavioural activation therapist will telephone participants on 3 occasions throughout the course of the 8 week program (first call within 2 weeks of randomisation than at week 4 and week 8) with a 4 week interval period between each call. The approximate duration of these telephone sessions will be 20-30 minutes and participants will be asked to complete activities from the workbook during the 4 week interval periods. The BA therapist will encourage participants to complete all relevant activities and participants can spend as much time as they wish completing each relevant stage through the work book.
Sponsors
UWA Medical School - Division Psychiatry
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
- Aged 65 years or over - Screens positive on at least one of two questions known as the "Whooley" depression screening questions: low mood and decreased interest or enjoyment in usual activities. - Resides in inner (RA2) or outer regional (RA3) or remote (RA4) Western Australia according to the Australian Standard Geographic Classification - Remoteness Areas (ASGC-RA) Classification 2011
Exclusion criteria
- Active suicidal plan - Current or past history of psychosis - Sensory impairment that interferes with effective communication over the phone or with reading font size 14 - Clinically significant cognitive impairment as evidenced by a score less than 27 on the Telephone Interview for Cognitive Status(TICSm)(Knopman et al, 2010) - Plans to move residence during the follow up period - Presence of a Major Depressive episode as assessed by administration of the SCID - 1
Outcome results
None listed