Mental Health, Low Vision Program Cuts Depression in AMD
Behavioral activation plus low vision rehab linked to reduced risk of depressive disorders
THURSDAY, July 10, 2014 (HealthDay News) -- For patients with age-related macular degeneration (AMD), an integrated mental health and low vision intervention can reduce the incidence of depressive disorders, according to a study published online July 9 in Ophthalmology.
Barry W. Rovner, M.D., from the Jefferson Hospital for Neuroscience in Philadelphia, and colleagues conducted a single-masked, attention-controlled, randomized trial involving 188 patients with AMD and subsyndromal depressive symptoms. Participants were randomized to in-home behavior activation, a structured behavioral treatment that aims to increase adaptive behaviors and achieve valued goals, and low vision rehabilitation (LVR) or to supportive therapy, a nondirective, psychological treatment that provides emotional support, plus LVR.
The researchers found that at four months, 12.6 percent of patients in the behavior activation group and 23.4 percent in the supportive therapy group developed a depressive disorder (relative risk, 0.54; P = 0.067). The relative risk was 0.51 in planned adjusted analyses (P = 0.04). In a mediational analysis, behavior activation plus LVR was suggested to prevent depression by enabling subjects to remain socially engaged. Greater improvements in functional vision were seen in the behavior activation group, although the between-group difference was not significant.
"Promoting interactions between ophthalmology, optometry, rehabilitation, psychiatry, and behavioral psychology may prevent depression in this population," the authors write.