Psychotherapy can be effective in prolonging periods free of depression in early senescent

Bacground: The Psychotherapy can be effective in prolonging periods free of depression in early senescent has been focused on the study. People refused medication agreed to come for psychotherapy are treated to get free from their depressive symptom. The main objective of the study was therefore using psychotherapy as a treatment module to stretch time free of depression. Further psycho education to give more information on depression and increase patient flexibility for the combination of anti-depressant with psychotherapy when needed. Methodology: The subjects selected for the study were 60 patients from ‘Nitte Rural Psychiatry Clinic’ Nitte Mangalore Karnataka, India. They were selected by random sampling technique. Medico – Psychological questionnaire for general neuroticism was administered to find out the extent of depression before and after psychotherapy. To find the difference between the age and depression before and after psychotherapy Carl Pearson’s Correlation coefficient method was carried out. Results: The results reveal that a non-significant difference between age groups with extent of depression in different age group of early senescent before and after psychotherapy (Chi-square=1.7913, p>0.05) at the 5 % level of significance and (Chi-square=2.4485, p>0.05) at the 5 % level of significance respectively. Further the Comparison of extent of depression before and after psychotherapy in 50-55, 56-60 age groups and as a total by Wilcoxon matched pairs test has been administered and the result reveals that significant differences between extent of depression before and after psychotherapy in 50-55yrs of age group (Z=2.5205, p<0.05) at the 5 % level of significance, 56-60yrs of age group (Z=2.2014, p<0.05) at the 5 % level of significance. It means that, the significant means that, the significance of 15.7%, 10.5%depression was decreased before and after psychotherapy respectively. A significant difference was observed between extent of depression before and after psychotherapy in 50 – 60yrs of age group (Z=3. 2958, p<0.05) at the 5 % level of significance. It means that, the significance of 13.0% depression was decreased after psychotherapy. Conclusion: The implication of this study was to develop insight and understanding among the clinicians that importance psychotherapy as treatment of depression.


Introduction:
Episodes of depression are characterized by feelings of guilt, social withdrawal, difficulty concentrating, tears and shame, and by physical manifestations such as either having a very poor appetite and difficulty sleeping with accompanying anxiety and agitation, or by eating and sleeping much more than usual, with a sense of having very little energy.Sometimes upon awakening, a depressed person feels that it is almost impossible to face the day and has a gnawing sense of dread and a feeling of physical heaviness. 1As we age, many people believe that it is normal or expected that a person should become more depressed. 2But that's not the case.Depression is not a normal part of aging, and studies show that most seniors feel satisfied with their lives, despite increased physical ailments. 2However, when older adults do have depression, it may be overlooked because seniors may show different, less obvious symptoms, and may be less inclined to experience or acknowledge feelings of sadness or grief. 3In addition, older adults may have more medical conditions such as heart disease, stroke or cancer, which may cause depressive symptoms, or they may be taking medications with side effects that contribute to depression. 4 Some older adults may experience what some doctors call vascular depression, also called arteriosclerotic depression or subcortical ischemic depression. 4Vascular depression may result when blood vessels become less flexible and harden over time, becoming constricted.Such hardening of vessels prevents normal blood flow to the body's organs, including the brain. 4Those with vascular depression may have, or be at risk for, a coexisting cardiovascular illness or stroke. 3Although many people assume that the highest rates of suicide are among the young, older white males age 85 and older actually have the highest suicide rate. 4Many have a depressive illness that their doctors may not detect, despite the fact that these suicide victims often visit their doctors within one month of their deaths. 5The majority of older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both. 4Research has shown that Psychotherapy alone also can be effective in prolonging periods free of depression, especially for older adults with minor depression, and it is particularly useful for those who are unable or unwilling to take antidepressant medication. 4,6  of the Study: i.
To find out the extent depression with and without psychotherapy as a treatment method.ii.
To find out the impact of psychotherapy in the treatment of depression further educating them to learn befits of antidepressant and psychotherapy in combination.

Objective of the Study: i.
To assess the extent of depression in the sample group.ii.
To find the effect of psychotherapy in early senescent.iii.
To find out the impact of Psychotherapy alone as a treatment for prolonging periods free of depression in early senescent.iv.
To find out the effectiveness of psycho education in this prolonged period free of depression to increase flexibility of patient for the combination anti-depressant and psychotherapy / need based treatment.

Hypothesis of the Study: i.
The Psychotherapy for the patient with minor depression prolongs periods free of depression in early senescent.ii.
Psycho education helps in patient's flexibility in need based treatment.

Materials and Methods: Assessment
Tool: Medico -Psychological Questionnaire for professionals: 7 The fifty items of the questionnaire are awarded two scores for positive response, one score for doubtful response and no score for negative response.The scale measures stable, unstable and neurotic emotionality of an individual.The items on

Results and Discussion:
A non-significant difference between age groups with extent of depression in different of early senescent (Chi-square=1.7913,p>0.05) at 5% level of significance (Table 1 and Figure 1).There is no difference found between age groups with extent of depression in different of early senescent before psychotherapy. 8A non-significant difference between age groups with extent of depression in different of early senescent after psychotherapy (Chi-square=2.4485,p>0.05) at the 5 % level of significance (Table 2 and Figure 2).There is no difference found between age groups with extent of depression in different of early senescent after psychotherapy.The current study findings were similar to other studies [9][10] but dissimilar to another one. 11As we age, many people believe that it is normal or expected that a person should become more depressed. 4Because there is a decline in their physical and mental abilities as the age advance which affects their social occupational functioning.4, 12-14 Depression is not a normal part of aging, and studies show that most seniors feel satisfied with their lives, despite increased physical ailments. [3][4]15The present study supports this fact.The data in the table significant difference were observed between extent of depression before and after psychotherapy in 50-55yrs of age group (Z=2.5205, p<0.05) at the 5 % level of significance (Table 3 and Figure 3).It means that, the significance of 15.7% depression was decreased after psychotherapy.Further, a significant difference was observed between extent of depression before and after psychotherapy in 56-60yrs of age group (Z=2.2014, p<0.05) at the 5 % level of significance.It means that, the significance of 10.5% depression was decreased after psychotherapy.Thus, it has been learned that a significant difference was observed between extent of depression before and after psychotherapy in 50-60yrs of age group (Z=3.2958,p<0.05) at the 5% level of significance (Table 3 and Figure 3).It means that, the significance of 13.0% depression was decreased after psychotherapy; which shows the impact of psychotherapy is effective in prolonging periods free of depression in early senescent has been focused on the study. 16

Conclusion:
Depression in senescent is common in human beings even though it is not a normal part of aging.Extent of depression increases with advancing age is not prominent among the study population.Depressive episodes are characterized by feelings of guilt, social withdrawal, difficulty concentrating, tears and shame, and by physical manifestations such as either having a very poor appetite and difficulty sleeping with accompanying anxiety and agitation, or by eating and sleeping much more than usual, with a sense of having very little energy.Sometimes upon awakening, a depressed person feels that it is almost impossible to face the day and has a gnawing sense of dread and a feeling of physical heaviness.Psychoanalysts are aware that a propensity to this kind of depression often has genetic and biochemical origins.Early problems in mood regulation can negatively impact a child's relationship, personality development and sense of self-regard.Additionally, traumas in early childhood, such as abuse, neglect, separation or loss can impact a child psychologically and neurobiological and cause a predisposition to depressive illness.Awareness about this fact that the combination of psychotherapy and anti-depressants should need based treatment and conceptualizing this fact and patient education in this regard should bring into limelight.In the present study, patients who are not willing to take medication are treated with psychotherapy alone in the cases of minor depression ad in early senescence and found free from depression.Further, this prolonged period free of depression eases the job of the therapist to put the capping for their balanced emotion.This will help the patient to have better insight and risk perception also become more flexible in their treatment of choice between anti-depressant and psychotherapy.

Figure 1 :Figure 2 :Figure 3 :
Figure 1: Graphic representation of extent of depression in different age groups of early senescent

Table 3 :
Comparison of extent of depression before and after psychotherapy in 50 -55, 56 -60 age groups and as a total by Wilcoxon matched pairs test

Table 1 :
Showing extent of depression in different age group of early senescent

Table 2 :
Showing extent of depression in different age group of early