Executive dysfunction, problem-solving and depression

People with executive dysfunction have problems setting goals, planning, initiating and sequencing behaviour. Executive dysfunction is often a symptom of depression and a team of researchers from Weill Cornell Medical College in New York studied the effectiveness of two different kinds of therapy in combating it in a study of 221 older adults with depression. Problem-solving therapy (PST) helps patients identify the most important problems in their lives, select solutions and make concrete plans for dealing with them while supportive therapy (ST) is more like counselling being based on 'active listening' and offering support in a non-judgemental environment. The participants were divided into two groups, each having either PST or ST, and received 12 weekly sessions of therapy. After six weeks both groups had shown comparable levels of improvement, however, the group receiving PST showed greater improvements after nine and 12 weeks and this difference was still there 24 weeks after the end of treatment. PST was particularly helpful for people who had cognitive problems and who had had more previous episodes of depression.

Alexopoulos, George S. ... [et al] - Problem-Solving Therapy and Supportive Therapy in Older Adults With Major Depression and Executive Dysfunction: effect on disability Archives of General Psychiatry January 2011, 68(1): 33-41