The primary goal of this study is to develop and test a depression-specific marital therapy
tailored for use with older adult populations.
Major depression has been associated with many individual and interpersonal problems in
later life, including inadequate social support, marital distress, spousal depression, poor
physical health, and higher rates of mortality. Marital therapy has shown promise as a
treatment for depression and coexisting marital distress in younger cohorts, and there is a
robust association between social support and depressive symptoms in older adults. The
combination of couple therapy and antidepressant medication may provide an ideal treatment
for older adults by targeting interpersonal and biochemical aspects of depression.
Couples interested in this study will complete an initial assessment with study personnel.
In Phase I, eligible couples will receive weekly marital therapy and the depressed partner
will receive medication management with a study doctor for 6 months. In Phase II, couples
will be randomly assigned to either the combination treatment (marital therapy plus
medication management) or medication management alone for 6 months. At the end of the
treatment phase, a thorough assessment will be completed. A follow-up assessment will be
completed 6 months after completion of treatment.
- One partner must receive a clinical diagnosis of major depressive disorder based upon
- Couples must be living together
- Either partner must report marital distress or tension
- Willing to take antidepressant medication and participate in weekly marital therapy
- The depressed partner cannot be involved in any other psychosocial treatment
- Score above 24 on the Mini Mental Status Exam
- Both partners meet diagnostic criteria for major depressive disorder based on our
- Coexisting bipolar or psychotic disorder
- Evidence of a primary substance abuse or dependence disorder
- Current ECT treatment
- Evidence of active and severe domestic violence