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Am J Geriatr Psychiatry ; 26(11): 1147-1162, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30224269

RESUMO

OBJECTIVE: To determine whether Calmer Life (CL) improved worry, generalized anxiety disorder-related (GAD-related) symptoms, anxiety, depression, sleep, trauma-related symptoms, functional status, and quality of life better than Enhanced Community Care with Resource Counseling (ECC-RC) at 6 months and 9 months. METHODS: A randomized, controlled, comparative-effectiveness study involving underserved, low-income, mostly minority neighborhoods in Houston, Texas, looked at individuals ≥50 with significant worry and interest in psychosocial treatment. Interventions were CL, cognitive behavioral therapy with resource counseling, facilitation of communication with primary care providers about worry/anxiety, integration of religion/spirituality, person-centered skill content and delivery and nontraditional community providers, ECC-RC, and enhanced standard community-based information/ resource counseling addressing basic unmet and mental health needs. Primary outcomes were worry and GAD-related symptom severity. Secondary outcomes were anxiety, depression, sleep difficulties, trauma-related symptoms, functional status, quality of life, service use and satisfaction. RESULTS: Similar, moderate improvements followed CL and ECC-RC on worry, GAD-related symptoms, anxiety, depression, sleep, trauma-related symptoms, and mental health quality of life at 6 and 9 months, but with symptoms at both times and higher satisfaction with CL at both. Fewer ECC-RC participants reported a hospital admission in the prior 3 months than those in CL at 6 and 9 months; at 9 months, fewer reported a visit with a provider in the previous 3 months. CONCLUSION: Both interventions showed similar improvements at 6 and 9 months, but symptoms remained that might require care. Either intervention or a combination may be useful for low-income older adults with identified worry/anxiety.


Assuntos
Ansiedade/terapia , Terapia Cognitivo-Comportamental , Relações Comunidade-Instituição , Aconselhamento/métodos , Área Carente de Assistência Médica , Idoso , Ansiedade/complicações , Depressão/complicações , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza/psicologia , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono/terapia , Resultado do Tratamento
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