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

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_{(1, 35)}?=?6.20, p?=?0.02) and with the reduction in overall depression severity at weeks 4, 8, and 12 (F_{(1, 35)}?=?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.

SUBMITTER: Arslanoglou E 

PROVIDER: S-EPMC6985925 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature