Secondary prevention of depressive symptoms in elderly inhabitants of residential homes

The effects of a multifaceted secondary prevention intervention in resident ial homes in the Netherlands were examined, using a quasi-experimental desi gn. In five experimental residential homes, the caregivers received three t raining sessions on detecting depression and on supporting depressed reside nts. Furthermore, an information session was organized for all personnel, a further session was organized for residents and their relatives, and sever al group interventions were offered. 213 residents participated in the stud y. 211 residents of five other residential homes, matched on basic variable s, served as a comparison group. Effects on depressive symptoms (geriatric depression scale) and health related quality of life (MOSSF-36) were measur ed at pretest and after the intervention, one year later. Because the drop- out rate was high and drop-outs differed significantly from the remaining p opulation, the scores of drop-outs were imputed. Since we used a quasiexper imental design, we controlled for confounding variables. Regression analyse s resulted in significant effects of the intervention on the GDS and on rol e functioning in the total population. When the analyses were limited to th ose scoring high on the GDS at pretest, significant effects were found on t he GDS, and on four domains of health-related quality of life: psychologica l distress, role functioning, pain and social functioning. The improvement in GDS scores in GDS cases was significantly larger than in other subjects. Our results suggest that general approaches aimed at a residential home ar e capable of influencing depressive symptoms in inhabitants. Possibly, it m ay not be necessary to wait until depressive symptoms have escalated and in habitants need extensive treatment. Copyright (C) 2001 John Wiley & Sons, L td.