New research suggests that for some, meeting with a nutritionist or dietary coach to learn about healthy eating is as effective for preventing major depression as meeting with a counselor or participating in talk therapy.
University of Pittsburgh researchers found this experience to be true for older black and white adults with mild symptoms of mood disorders.
Their findings were published online recently in Psychiatric Services.
“Depression is common and treatments often don’t completely resolve the disability that attends the illness,” said senior author Charles F. Reynolds III, M.D.
Sadness, fatigue, and disinterest in activities that used to bring pleasure can leave patients isolated and unable to care for themselves.
“That’s why we’re very interested in finding ways to prevent the disease in those we know are particularly vulnerable,” he said.
“Avoiding episodes of major depression can help people stay happy and engaged in their communities, as well as reduce health care costs.”
Rsearchers assessed whether problem-solving therapy for primary care (PST-PC), could prevent elderly adults who have mild symptoms of depression from developing full-blown disease.
This approach uses a scientifically proven seven-step technique delivered by non-mental-health professionals to help patients resolve difficulties and thus improve coping skills and confidence.
Instead of comparing the PST-PC participants to those who received “usual care,” which would most likely mean receiving no intervention, the team took the novel approach of comparing the PST-PC group to participants who underwent a program of dietary coaching at a similar visit interval for the same number of hours.
Researchers used an innovative, culturally tailored approach to recruit and retain African-American study participants, based on a method developed by Sandra Quinn, Ph.D., and Stephen Thomas, Ph.D., co-investigators from the University of Maryland Center for Health Equity.
“Because racial minorities are at greater risk for depression, in part due to socioeconomic disadvantages, lower educational attainment, and a greater likelihood of other medical problems, we established a foundation of trust working through churches and community-based organizations in black communities,” said Quinn.
Of the 244 participants, 90, or more than a third, were African-American.
“Previous studies we and others have done indicate about 25 percent of people in later life who are mildly depressed become seriously depressed in the next one to two years,” Reynolds said.
The researchers found about nine percent of the people in each intervention arm went on to experience an episode of major depression, and they all had a similar reduction in depressive symptoms over the two-year study period.
Also, both approaches were equally successful among black and white participants.
“This project tells us that interventions in which people actively engage in managing their own life problems, such as financial or health issues, tend to have a positive effect on well-being and a protective effect against the onset of depression.”
“We suspect we had a higher than usual proportion of black participants because community leaders championed the project, no medication was prescribed, and treatment could be delivered at home or at other non-clinical settings,” said Thomas.
“Lifestyle interventions, such as dietary coaching, may be more culturally appropriate and acceptable in racial-ethnic minority communities.”
In a new project, the researchers will examine whether PST-PC can be effectively administered by lay health counselors in low- and middle-income countries such as India.