Negative Emotions and the Course of Depression During Psychotherapy in Suicidal Older Adults With Depression and Cognitive Impairment.

TitleNegative Emotions and the Course of Depression During Psychotherapy in Suicidal Older Adults With Depression and Cognitive Impairment.
Publication TypeJournal Article
Year of Publication2019
AuthorsArslanoglou E, Banerjee S, Pantelides J, Evans L, Kiosses DN
JournalAm J Geriatr Psychiatry
Volume27
Issue12
Pagination1287-1295
Date Published2019 Dec
ISSN1545-7214
Abstract

OBJECTIVE: The study examines the relationship of negative emotions with: 1) non-emotional symptoms (e.g., vegetative and physical symptoms) and 2) the course of depression in suicidal older adults with Major Depressive Disorder (MDD) and cognitive impairment treated with psychotherapy.

DESIGN: The authors identified a subgroup of participants (N = 26) who expressed suicidal ideation at Baseline or Week 12 from a randomized controlled trial (RCT) of two psychosocial interventions, Problem Adaptation Therapy (PATH) and Supportive Therapy for Cognitively Impaired. The authors assessed negative emotions, non-emotional symptoms of depression, depression severity, and suicidal ideation at entry, week 4, week 8, and week 12.

PARTICIPANTS: Participants were 65 years and older and had a diagnosis of unipolar depression, varying degrees of cognitive impairment (up to moderate dementia) and suicidal ideation.

SETTING: The study was conducted in the Outpatient Department of New York Presbyterian/Weill Cornell Medicine in Westchester, NY.

MEASUREMENTS: Negative emotions and non-emotional items were identified with the 24-item Hamilton Depression Rating Scale (Ham-D).

RESULTS: Among participants with suicidal ideation, the reduction in negative emotions from baseline to week 4, week 4 to week 8, and week 8 to week 12 was significantly associated with the reduction in non-emotional symptoms of depression at weeks 4, 8, and 12 (F = 6.20, p = 0.02) and with the reduction in overall depression severity at weeks 4, 8, and 12 (F = 26.63, p <0.0001) after controlling for depression severity at baseline (HAM-D total score) and time trends.

CONCLUSION: Our findings may guide the treatment of older patients with depression and suicidal ideation to help reduce depression and suicide risk.

DOI10.1016/j.jagp.2019.08.018
Alternate JournalAm J Geriatr Psychiatry
PubMed ID31582195
PubMed Central IDPMC6985925
Grant ListP50 MH113838 / MH / NIMH NIH HHS / United States
P30 MH085943 / MH / NIMH NIH HHS / United States
R33 MH110542 / MH / NIMH NIH HHS / United States
R61 MH110542 / MH / NIMH NIH HHS / United States
R01 MH091045 / MH / NIMH NIH HHS / United States