Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community

Wanvisa Saisanan Na Ayudhaya,1 Nuttorn Pityaratstian,2 Wiroj Jiamjarasrangsi1 1Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandCorrespondence: Wi...

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Autores principales:	Saisanan Na Ayudhaya W, Pityaratstian N, Jiamjarasrangsi W
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	behavioral activation community depression older adults Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/0412ef0aef874501b7f5073284356f87
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spelling	oai:doaj.org-article:0412ef0aef874501b7f5073284356f872021-12-02T12:53:31ZEffectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community1178-1998https://doaj.org/article/0412ef0aef874501b7f5073284356f872020-12-01T00:00:00Zhttps://www.dovepress.com/effectiveness-of-behavioral-activation-in-treating-thai-older-adults-w-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Wanvisa Saisanan Na Ayudhaya,1 Nuttorn Pityaratstian,2 Wiroj Jiamjarasrangsi1 1Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandCorrespondence: Wiroj JiamjarasrangsiDepartment of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, ThailandTel +662 2564000 Ext. 3700Fax +662 2564292Email wjiamja@gmail.comBackground: In recent years, behavioral activation (BA) has attracted increased interest as an effective depression treatment. However, empirical evidence supporting its effectiveness in non-Western countries is currently limited.Objective: To examine the effectiveness of BA in reducing depressive symptoms, stress, and anxiety among Thai older adults with subthreshold depression.Methods and Subjects: A clustered randomized controlled trial was conducted in two health promoting hospitals (HPHs) in the Samut Songkhram province of Thailand. One hospital was used for the intervention (BA+usual care group) and the other for the control (usual care-only group). Each HPH randomly selected 41 eligible older adults residing in their jurisdictions to take part in the study. Mental health outcomes were assessed using the Thai Geriatric Depression Scale (TGDS) and Depression Anxiety Stress Scales (DASS). The BA effectiveness was evaluated using generalized estimating equations (GEE) at a group level and the reliable change index (RCI) at the individual level.Results: Over 9 months, the adjusted mean change in depression (TGDS) scores [− 2.47 (95% CI: − 3.84, − 1.00)], mental health status (DASS), specifically depression and stress score [− 1.47 and − 1.87 (95% CI: − 2.43, − 0.50 and − 2.94, − 0.79, respectively)], improved significantly in the BA+usual care group compared to the usual care-only group, whereas anxiety score improved significantly only at 6 months [− 0.87 (95% CI: − 1.52, − 0.23)]. Additional RCI analysis showed that BA was directly associated with 14.63 to 24.39% points increase in the reliable improvement of depressive outcome compared to the usual care-only group.Conclusion: This study showed that the BA effectively improved depression, stress, and anxiety in older adults with subthreshold depression in a Thai community setting. Future research should evaluate the longer-term effectiveness of BA in diverse population groups.Keywords: behavioral activation, community, depression, older adultsSaisanan Na Ayudhaya WPityaratstian NJiamjarasrangsi WDove Medical Pressarticlebehavioral activationcommunitydepressionolder adultsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 2363-2374 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	behavioral activation community depression older adults Geriatrics RC952-954.6
spellingShingle	behavioral activation community depression older adults Geriatrics RC952-954.6 Saisanan Na Ayudhaya W Pityaratstian N Jiamjarasrangsi W Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community
description	Wanvisa Saisanan Na Ayudhaya,1 Nuttorn Pityaratstian,2 Wiroj Jiamjarasrangsi1 1Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandCorrespondence: Wiroj JiamjarasrangsiDepartment of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, ThailandTel +662 2564000 Ext. 3700Fax +662 2564292Email wjiamja@gmail.comBackground: In recent years, behavioral activation (BA) has attracted increased interest as an effective depression treatment. However, empirical evidence supporting its effectiveness in non-Western countries is currently limited.Objective: To examine the effectiveness of BA in reducing depressive symptoms, stress, and anxiety among Thai older adults with subthreshold depression.Methods and Subjects: A clustered randomized controlled trial was conducted in two health promoting hospitals (HPHs) in the Samut Songkhram province of Thailand. One hospital was used for the intervention (BA+usual care group) and the other for the control (usual care-only group). Each HPH randomly selected 41 eligible older adults residing in their jurisdictions to take part in the study. Mental health outcomes were assessed using the Thai Geriatric Depression Scale (TGDS) and Depression Anxiety Stress Scales (DASS). The BA effectiveness was evaluated using generalized estimating equations (GEE) at a group level and the reliable change index (RCI) at the individual level.Results: Over 9 months, the adjusted mean change in depression (TGDS) scores [− 2.47 (95% CI: − 3.84, − 1.00)], mental health status (DASS), specifically depression and stress score [− 1.47 and − 1.87 (95% CI: − 2.43, − 0.50 and − 2.94, − 0.79, respectively)], improved significantly in the BA+usual care group compared to the usual care-only group, whereas anxiety score improved significantly only at 6 months [− 0.87 (95% CI: − 1.52, − 0.23)]. Additional RCI analysis showed that BA was directly associated with 14.63 to 24.39% points increase in the reliable improvement of depressive outcome compared to the usual care-only group.Conclusion: This study showed that the BA effectively improved depression, stress, and anxiety in older adults with subthreshold depression in a Thai community setting. Future research should evaluate the longer-term effectiveness of BA in diverse population groups.Keywords: behavioral activation, community, depression, older adults
format	article
author	Saisanan Na Ayudhaya W Pityaratstian N Jiamjarasrangsi W
author_facet	Saisanan Na Ayudhaya W Pityaratstian N Jiamjarasrangsi W
author_sort	Saisanan Na Ayudhaya W
title	Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community
title_short	Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community
title_full	Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community
title_fullStr	Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community
title_full_unstemmed	Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community
title_sort	effectiveness of behavioral activation in treating thai older adults with subthreshold depression residing in the community
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/0412ef0aef874501b7f5073284356f87
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Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community

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