A randomized controlled trial of Problem-solving versus Cognitive restructuring Of Medically Ill Seniors with depression (PROMISE-D trial)

INTERVENTION: Problem‐solving therapy: Participants are taught problem solving strategies for dealing with illness and other stress related problems. 10 x 1 hour weekly individual sessions Cognitive Therapy: Participants are introduced to the role of thoughts in emotions, learn to recognise and challenge unhelpful beliefs and construct behavioural experiments to test out their concerns. 10, 1 hour weekly individual sessions CONDITION: Depressive Illness in the context of one or more medical illnesses PRIMARY OUTCOME: Depressive symptoms (Geriatric Depression Scale) Diagnosis of depression (PRIME‐MD) Severity of depression (Hamilton Depression Rating Scale) SECONDARY OUTCOME: Anxiety (Beck Anxiety Inventory) Health Care Utilization Quality of life (SF‐36) INCLUSION CRITERIA: (1) diagnosis of major or minor depressive disorder or dysthymia; (2) if taking anti‐depressant medication, a stable dose for > 8 weeks; (3) have not received electroconvulsive therapy within 6 mths (to exclude memory problems) and (4) sufficient English.