Prevention of Depression in Low & Middle Income Countries: NIMH-sponsored Intervention Development

VUMC Psychiatry Grand Rounds March 31, 2023
Charles F. Reynolds III, MD
Distinguished Professor of Psychiatry and UPMC Endowed Professor in Geriatric Psychiatry Emeritus
University of Pittsburgh School of Medicine and Graduate School of Public Health
Editor, American Journal of Geriatric Psychiatry
Co-Chair, National Academy of Science Engineering and Medicine Planning Committee for "Meeting the Mental Health Needs of Older Americans"
Summary
Dr. Reynolds will present the development and results of an NIMH- sponsored randomized clinical trial for the indicated prevention of depression in older adults living in Goa, India. He will address the public health importance of depression prevention and the use of lay counselors. Relative to enhanced care as usual, the investigators found that lay counselors were able to deliver a culturally modified version of problem solving therapy, behavioral treatment for insomnia, and behavioral activation, resulting in a meaningful reduction in rates of incident major depression among participants receiving the intervention, as compared with care as usual. Implications for practice and further research will be discussed.
The activity is designed to help the learner
1. Discuss a public health and clinical rationale for the prevention of depression in older adults.
2. Differentiate universal, selective, and indicated prevention of depression
3. Identify the role, effectiveness and limitation of lay counselors for depression prevention (especially in LMICs)
4. Review the results of the NIMH-sponsored "DIL" randomized clinical trial for depression prevention in Goa, India