The role of occupational therapy in the management of depression

Intervenir auprès des personnes souffrant de dépression en tenant compte de la dimension spirituelle

Cet article fait état de données démographiques et des coûts substantiels de la dépression. Il la présente sous l'angle de la médecine occidentale et de l'épidémiologie. Une recension des écrits permet de considérer les objectifs, les modèles de pratique et les modalités retrouvés dans l'intervention ergothérapique auprès d'une population déprimée. Une définition de la santé spirituelle est proposée puis son implication en ergothérapie est abordée. Finalement, l'auteure présente l' ébauche d'un modèle pour l'intervention.

Home-based chronic care. An expanded integrative model for home health professionals

The Chronic Care Model (CCM) developed by is an influential and accepted guide for the care of patients with chronic disease. Wagner acknowledges a current healthcare focus on acute care needs that often circumvents chronic care coordination. He identifies the need for a "division of labor" to assist the primary care physician with this neglected function. This article posits that the role of chronic care coordination assistance and disease management fits within the purview of home healthcare and should be central to home health chronic care delivery. An expanded Home-Based Chronic Care Model (HBCCM) is described that builds on Wagner's model and integrates salient theories from fields beyond medicine. The expanded model maximizes the potential for disease self-management success and is intended to provide a foundation for home health's integral role in chronic disease management.

Kontrollierte Studien zur Wirksamkeit von Ergotherapie bei �lteren

OBJECTIVE

To identify the evidence for the efficacy of occupational therapy on prioritized diseases and disabilities of the elderly.

METHOD

Reviews, meta-analyses and clinical trials with control group design regarding "occupational therapy" were identified by an electronic search of pubmed and reviewed based on the CONSORT-Statement. The study results were summarised in regard to diseases and commented considering further literature.

RESULTS

A total of 31 studies were identified: 10 on stroke, 6 on dementia, 5 on prevention of falls, growing loneliness or inactivity, 4 on need of nursing care, and 6 on other diseases or disabilities. There is evidence for a positive efficacy of occupational therapy on the level of several controlled trials or reviews.

CONCLUSION

Especially in Germany, further research specific to occupational therapy is needed in the fields of depression, diabetes mellitus and nursing care in the community.

Breaking the myths: new treatment approaches for chronic depression

BACKGROUND

Chronic depressive disorders are common, accounting for approximately one-third of all cases of depression and posing a major public health problem. In the past, chronic depression has been thought to be treatment-resistant, and evidence suggests that it is currently underdiagnosed, misdiagnosed, and suboptimally treated.

OBJECTIVES

To review the subtypes of chronic depression and the evidence-base concerning their optimal treatment and to discuss some key clinical issues and areas of future research.

METHODS

We identified key studies and randomized controlled trials (RCTs) by systematically searching electronic databases and hand searching specialist journals and bibliographies.

RESULTS

Chronic depressive disorders respond well to standard pharmacologic interventions in the acute and maintenance phases of treatment. Standard psychotherapies alone may not be efficacious for chronic depression (especially dysthymia). Recent evidence suggests that treatment combining psychotherapy and medications may be superior to either treatment alone.

CONCLUSIONS

Chronic depressive disorders are amenable to treatment, provided that intervention is both thorough and intensive. Although our knowledge about the optimal treatment of chronic depression has developed rapidly, changes in clinical practice have been slower to evolve. Further research is required to assess the effectiveness of multimodal interventions for chronic depression in more naturalistic settings.

The effect of leisure activity on depression in the elderly: implications for the field of occupational therapy

The purpose of this annotated review of literature was to examine the effect of leisure activity on depression in the elderly. Despite some limitations, the literature, in general, suggests an inverse correlation between leisure activity and depression in the elderly. Individuals who engaged in leisure activity, whether it was physical exercise or more sedentary activity such as card games, were less depressed than individuals who did not engage in leisure activity. More scientific research is needed, however, to confirm this effect. Further studies could serve to define leisure activity as a tool for treatment in the field of occupational therapy.