Rehab Therapy Decreases Depression in Patients with AMD

A new rehabilitation therapy may reduce the risk of depression in patients with age-related macular degeneration (AMD) by 50%, according to a recent study.

“The depression is a response to disability, so we reasoned an effective treatment would be to reduce the disability through rehabilitation,” said Barry Rovner, MD, study co-author and professor of psychiatry and neurology at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia.
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A team of psychologists, ophthalmologists, occupational therapists, and optometrists studied behavior activation in 188 participants (mean age of 84) who suffered from bilateral AMD and had a best-corrected vision of less than 20/70; 70% were women and 50% lived alone.

Each participant exhibited mild symptoms of depression based on a 9 questions subtest on a Patient Health Questionnaire (PHQ-9).

For the study, participants completed 6 one-hour sessions with a therapist over a 2-month period. Half the participants received behavior activation therapy, including assistance on using low-vision devices in order to increase their social activities, set personal goals, and make minor changes around the home. The remaining participants talked about their difficulties to a therapist, but did not receive behavior activation or low-vision occupational therapy.

All participants were allowed to take antidepressants; less than 10% did so. All received medical management for AMD from their primary eye care provider.

By 4 months, 12 people in the control group and 7 in the behavior activation group had either withdrawn from the trial or passed away.

Of the remaining 169 participants, 23.4% of the control group and 12.6% of the behavior activation group developed clinical depression.

Overall, behavior activation reduced the risk of depression by 50%. It had the most benefit in participants with the worst vision (less than 20/100), reducing the risk of depression about 60% in this target audience.

The complete study is published in the July issue of Ophthalmology.

-Michelle Canales

Reference:

National Institutes of Health. Rehabilitation helps prevent depression from age-related vision loss [press release]. July 9, 2014. www.nih.gov/news/health/jul2014/nei-09.htm. Accessed July 10, 2014.