Differential Psychological Treatment Effects in Patients With Late-Life Depression and a History of Childhood Maltreatment
•What is the primary question addressed by this study?Does childhood maltreatment affect the psychological treatment outcomes in late-life depression?•What is the main finding of this study?In older individuals with depression and childhood maltreatment, both specific and non-specific psychotherapy...
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| Veröffentlicht in: | The American journal of geriatric psychiatry 2024-11, Vol.32 (11), p.1325-1336 |
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| creator | Müller, Julia Elsaesser, Moritz Müller, Wiebke Hellmich, Martin Hammen, Magdalena Zehender, Nadine Riedel-Heller, Steffi Bewernick, Bettina H. Wagner, Michael Frölich, Lutz Peters, Oliver Dafsari, Forugh S. Domschke, Katharina Jessen, Frank Hautzinger, Martin Schramm, Elisabeth |
| description | •What is the primary question addressed by this study?Does childhood maltreatment affect the psychological treatment outcomes in late-life depression?•What is the main finding of this study?In older individuals with depression and childhood maltreatment, both specific and non-specific psychotherapy equally reduce depressive symptoms. However, in patients without childhood maltreatment, cognitive behavioral therapy for late-life-depression demonstrates greater efficacy over non-specific supportive psychotherapy.•What is the meaning of the finding?Practioners should consider a history of early trauma in their choice between specific and non-specific interventions.
This is the first interventional study to assess the impact of childhood maltreatment (CM) on psychological treatment outcomes in patients with late-life depression (LLD).
This is a secondary analysis of a multicenter, randomized controlled trial with 251 participants aged ≥60 years with moderate to severe depression. Participants were randomly assigned to cognitive behavioral therapy for late life depression (LLD-CBT) or to a supportive intervention (SUI). Treatment outcomes were measured by changes in the Geriatric Depression Scale (GDS).
In the intention-to-treat sample (n = 229), both LLD-CBT (n = 115) and SUI (n = 114) significantly reduced depressive symptoms in patients with CM, with large effects at post-treatment (d = 0.95 [95% CI: 0.65 to 1.25] in LLD-CBT; d = 0.82 [95% CI: 0.52 to 1.12] in SUI). A significant treatment group*CM interaction (F(1,201.31) = 4.71; p = .031) indicated greater depressive symptom reduction in LLD-CBT compared to SUI at week 5 and post-treatment for patients without CM, but not at 6-month follow-up. Across both treatments, higher severity of the CM subtype ‘physical neglect’ was associated with a smaller depressive symptom reduction (F(1,207.16) = 5.37; p = .021).
Specific and non-specific psychotherapy effectively reduced depressive symptoms in older individuals with depression and early trauma. For patients without early trauma, LLD-CBT may be preferable over SUI. Considering early trauma subtypes may contribute to develop personalized treatment approaches. |
| doi_str_mv | 10.1016/j.jagp.2024.05.006 |
| format | Article |
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This is the first interventional study to assess the impact of childhood maltreatment (CM) on psychological treatment outcomes in patients with late-life depression (LLD).
This is a secondary analysis of a multicenter, randomized controlled trial with 251 participants aged ≥60 years with moderate to severe depression. Participants were randomly assigned to cognitive behavioral therapy for late life depression (LLD-CBT) or to a supportive intervention (SUI). Treatment outcomes were measured by changes in the Geriatric Depression Scale (GDS).
In the intention-to-treat sample (n = 229), both LLD-CBT (n = 115) and SUI (n = 114) significantly reduced depressive symptoms in patients with CM, with large effects at post-treatment (d = 0.95 [95% CI: 0.65 to 1.25] in LLD-CBT; d = 0.82 [95% CI: 0.52 to 1.12] in SUI). A significant treatment group*CM interaction (F(1,201.31) = 4.71; p = .031) indicated greater depressive symptom reduction in LLD-CBT compared to SUI at week 5 and post-treatment for patients without CM, but not at 6-month follow-up. Across both treatments, higher severity of the CM subtype ‘physical neglect’ was associated with a smaller depressive symptom reduction (F(1,207.16) = 5.37; p = .021).
Specific and non-specific psychotherapy effectively reduced depressive symptoms in older individuals with depression and early trauma. For patients without early trauma, LLD-CBT may be preferable over SUI. Considering early trauma subtypes may contribute to develop personalized treatment approaches.</description><identifier>ISSN: 1064-7481</identifier><identifier>ISSN: 1545-7214</identifier><identifier>EISSN: 1545-7214</identifier><identifier>DOI: 10.1016/j.jagp.2024.05.006</identifier><identifier>PMID: 38824050</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Adult Survivors of Child Abuse - psychology ; Aged ; Aged, 80 and over ; Child Abuse - psychology ; childhood maltreatment ; cognitive behavioral therapy ; Cognitive Behavioral Therapy - methods ; Depression - therapy ; early trauma ; Female ; Humans ; late-life depression ; Male ; Middle Aged ; non-specific supportive intervention ; older age ; Treatment Outcome</subject><ispartof>The American journal of geriatric psychiatry, 2024-11, Vol.32 (11), p.1325-1336</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2010-fc997ab784c14265549f0813dd20c97c884acbfa1d1ea758d584656ebdef4aaf3</citedby><cites>FETCH-LOGICAL-c2010-fc997ab784c14265549f0813dd20c97c884acbfa1d1ea758d584656ebdef4aaf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38824050$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Müller, Julia</creatorcontrib><creatorcontrib>Elsaesser, Moritz</creatorcontrib><creatorcontrib>Müller, Wiebke</creatorcontrib><creatorcontrib>Hellmich, Martin</creatorcontrib><creatorcontrib>Hammen, Magdalena</creatorcontrib><creatorcontrib>Zehender, Nadine</creatorcontrib><creatorcontrib>Riedel-Heller, Steffi</creatorcontrib><creatorcontrib>Bewernick, Bettina H.</creatorcontrib><creatorcontrib>Wagner, Michael</creatorcontrib><creatorcontrib>Frölich, Lutz</creatorcontrib><creatorcontrib>Peters, Oliver</creatorcontrib><creatorcontrib>Dafsari, Forugh S.</creatorcontrib><creatorcontrib>Domschke, Katharina</creatorcontrib><creatorcontrib>Jessen, Frank</creatorcontrib><creatorcontrib>Hautzinger, Martin</creatorcontrib><creatorcontrib>Schramm, Elisabeth</creatorcontrib><title>Differential Psychological Treatment Effects in Patients With Late-Life Depression and a History of Childhood Maltreatment</title><title>The American journal of geriatric psychiatry</title><addtitle>Am J Geriatr Psychiatry</addtitle><description>•What is the primary question addressed by this study?Does childhood maltreatment affect the psychological treatment outcomes in late-life depression?•What is the main finding of this study?In older individuals with depression and childhood maltreatment, both specific and non-specific psychotherapy equally reduce depressive symptoms. However, in patients without childhood maltreatment, cognitive behavioral therapy for late-life-depression demonstrates greater efficacy over non-specific supportive psychotherapy.•What is the meaning of the finding?Practioners should consider a history of early trauma in their choice between specific and non-specific interventions.
This is the first interventional study to assess the impact of childhood maltreatment (CM) on psychological treatment outcomes in patients with late-life depression (LLD).
This is a secondary analysis of a multicenter, randomized controlled trial with 251 participants aged ≥60 years with moderate to severe depression. Participants were randomly assigned to cognitive behavioral therapy for late life depression (LLD-CBT) or to a supportive intervention (SUI). Treatment outcomes were measured by changes in the Geriatric Depression Scale (GDS).
In the intention-to-treat sample (n = 229), both LLD-CBT (n = 115) and SUI (n = 114) significantly reduced depressive symptoms in patients with CM, with large effects at post-treatment (d = 0.95 [95% CI: 0.65 to 1.25] in LLD-CBT; d = 0.82 [95% CI: 0.52 to 1.12] in SUI). A significant treatment group*CM interaction (F(1,201.31) = 4.71; p = .031) indicated greater depressive symptom reduction in LLD-CBT compared to SUI at week 5 and post-treatment for patients without CM, but not at 6-month follow-up. Across both treatments, higher severity of the CM subtype ‘physical neglect’ was associated with a smaller depressive symptom reduction (F(1,207.16) = 5.37; p = .021).
Specific and non-specific psychotherapy effectively reduced depressive symptoms in older individuals with depression and early trauma. For patients without early trauma, LLD-CBT may be preferable over SUI. Considering early trauma subtypes may contribute to develop personalized treatment approaches.</description><subject>Adult Survivors of Child Abuse - psychology</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child Abuse - psychology</subject><subject>childhood maltreatment</subject><subject>cognitive behavioral therapy</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Depression - therapy</subject><subject>early trauma</subject><subject>Female</subject><subject>Humans</subject><subject>late-life depression</subject><subject>Male</subject><subject>Middle Aged</subject><subject>non-specific supportive intervention</subject><subject>older age</subject><subject>Treatment Outcome</subject><issn>1064-7481</issn><issn>1545-7214</issn><issn>1545-7214</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1uGyEURlHVqvnrC3RRsexmppcZYBipm8pJk0qumkWiLhGGS4w1HlzAldynL5aTLrsC7j3fJ3EIec-gZcDkp027MU-7toOOtyBaAPmKnDPBRTN0jL-ud5C8GbhiZ-Qi5w1UYpT8LTnrleo4CDgnf66D95hwLsFM9D4f7DpO8SnY-npIaMq2ruhNZWzJNMz03pRQR5n-DGVNl6Zgswwe6TXuEuYc4kzN7KihdyGXmA40erpYh8mtY3T0u5nKS-sVeePNlPHd83lJHr_ePCzumuWP22-LL8vGdsCg8XYcB7MaFLeMd1IIPnpQrHeuAzsOVilu7Mob5hiaQSgnFJdC4sqh58b4_pJ8PPXuUvy1x1z0NmSL02RmjPuse5A9l6ofx4p2J9SmmHNCr3cpbE06aAb66Fxv9NG5PjrXIHQ1WkMfnvv3qy26f5EXyRX4fAKw_vJ3wKSzrQ4tupCqVu1i-F__XxPhlFM</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Müller, Julia</creator><creator>Elsaesser, Moritz</creator><creator>Müller, Wiebke</creator><creator>Hellmich, Martin</creator><creator>Hammen, Magdalena</creator><creator>Zehender, Nadine</creator><creator>Riedel-Heller, Steffi</creator><creator>Bewernick, Bettina H.</creator><creator>Wagner, Michael</creator><creator>Frölich, Lutz</creator><creator>Peters, Oliver</creator><creator>Dafsari, Forugh S.</creator><creator>Domschke, Katharina</creator><creator>Jessen, Frank</creator><creator>Hautzinger, Martin</creator><creator>Schramm, Elisabeth</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202411</creationdate><title>Differential Psychological Treatment Effects in Patients With Late-Life Depression and a History of Childhood Maltreatment</title><author>Müller, Julia ; Elsaesser, Moritz ; Müller, Wiebke ; Hellmich, Martin ; Hammen, Magdalena ; Zehender, Nadine ; Riedel-Heller, Steffi ; Bewernick, Bettina H. ; Wagner, Michael ; Frölich, Lutz ; Peters, Oliver ; Dafsari, Forugh S. ; Domschke, Katharina ; Jessen, Frank ; Hautzinger, Martin ; Schramm, Elisabeth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2010-fc997ab784c14265549f0813dd20c97c884acbfa1d1ea758d584656ebdef4aaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult Survivors of Child Abuse - psychology</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child Abuse - psychology</topic><topic>childhood maltreatment</topic><topic>cognitive behavioral therapy</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>Depression - therapy</topic><topic>early trauma</topic><topic>Female</topic><topic>Humans</topic><topic>late-life depression</topic><topic>Male</topic><topic>Middle Aged</topic><topic>non-specific supportive intervention</topic><topic>older age</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Müller, Julia</creatorcontrib><creatorcontrib>Elsaesser, Moritz</creatorcontrib><creatorcontrib>Müller, Wiebke</creatorcontrib><creatorcontrib>Hellmich, Martin</creatorcontrib><creatorcontrib>Hammen, Magdalena</creatorcontrib><creatorcontrib>Zehender, Nadine</creatorcontrib><creatorcontrib>Riedel-Heller, Steffi</creatorcontrib><creatorcontrib>Bewernick, Bettina H.</creatorcontrib><creatorcontrib>Wagner, Michael</creatorcontrib><creatorcontrib>Frölich, Lutz</creatorcontrib><creatorcontrib>Peters, Oliver</creatorcontrib><creatorcontrib>Dafsari, Forugh S.</creatorcontrib><creatorcontrib>Domschke, Katharina</creatorcontrib><creatorcontrib>Jessen, Frank</creatorcontrib><creatorcontrib>Hautzinger, Martin</creatorcontrib><creatorcontrib>Schramm, Elisabeth</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Müller, Julia</au><au>Elsaesser, Moritz</au><au>Müller, Wiebke</au><au>Hellmich, Martin</au><au>Hammen, Magdalena</au><au>Zehender, Nadine</au><au>Riedel-Heller, Steffi</au><au>Bewernick, Bettina H.</au><au>Wagner, Michael</au><au>Frölich, Lutz</au><au>Peters, Oliver</au><au>Dafsari, Forugh S.</au><au>Domschke, Katharina</au><au>Jessen, Frank</au><au>Hautzinger, Martin</au><au>Schramm, Elisabeth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential Psychological Treatment Effects in Patients With Late-Life Depression and a History of Childhood Maltreatment</atitle><jtitle>The American journal of geriatric psychiatry</jtitle><addtitle>Am J Geriatr Psychiatry</addtitle><date>2024-11</date><risdate>2024</risdate><volume>32</volume><issue>11</issue><spage>1325</spage><epage>1336</epage><pages>1325-1336</pages><issn>1064-7481</issn><issn>1545-7214</issn><eissn>1545-7214</eissn><abstract>•What is the primary question addressed by this study?Does childhood maltreatment affect the psychological treatment outcomes in late-life depression?•What is the main finding of this study?In older individuals with depression and childhood maltreatment, both specific and non-specific psychotherapy equally reduce depressive symptoms. However, in patients without childhood maltreatment, cognitive behavioral therapy for late-life-depression demonstrates greater efficacy over non-specific supportive psychotherapy.•What is the meaning of the finding?Practioners should consider a history of early trauma in their choice between specific and non-specific interventions.
This is the first interventional study to assess the impact of childhood maltreatment (CM) on psychological treatment outcomes in patients with late-life depression (LLD).
This is a secondary analysis of a multicenter, randomized controlled trial with 251 participants aged ≥60 years with moderate to severe depression. Participants were randomly assigned to cognitive behavioral therapy for late life depression (LLD-CBT) or to a supportive intervention (SUI). Treatment outcomes were measured by changes in the Geriatric Depression Scale (GDS).
In the intention-to-treat sample (n = 229), both LLD-CBT (n = 115) and SUI (n = 114) significantly reduced depressive symptoms in patients with CM, with large effects at post-treatment (d = 0.95 [95% CI: 0.65 to 1.25] in LLD-CBT; d = 0.82 [95% CI: 0.52 to 1.12] in SUI). A significant treatment group*CM interaction (F(1,201.31) = 4.71; p = .031) indicated greater depressive symptom reduction in LLD-CBT compared to SUI at week 5 and post-treatment for patients without CM, but not at 6-month follow-up. Across both treatments, higher severity of the CM subtype ‘physical neglect’ was associated with a smaller depressive symptom reduction (F(1,207.16) = 5.37; p = .021).
Specific and non-specific psychotherapy effectively reduced depressive symptoms in older individuals with depression and early trauma. For patients without early trauma, LLD-CBT may be preferable over SUI. Considering early trauma subtypes may contribute to develop personalized treatment approaches.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>38824050</pmid><doi>10.1016/j.jagp.2024.05.006</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The American journal of geriatric psychiatry, 2024-11, Vol.32 (11), p.1325-1336 |
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| subjects | Adult Survivors of Child Abuse - psychology Aged Aged, 80 and over Child Abuse - psychology childhood maltreatment cognitive behavioral therapy Cognitive Behavioral Therapy - methods Depression - therapy early trauma Female Humans late-life depression Male Middle Aged non-specific supportive intervention older age Treatment Outcome |
| title | Differential Psychological Treatment Effects in Patients With Late-Life Depression and a History of Childhood Maltreatment |
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