Improvements in Functional Disability After Psychotherapy for Depression Are Associated With Reduced Suicide Ideation Among Older Adults

Lutz, Julie; Mackin, R. Scott; Otero, Marcela C.; Morin, Ruth; Bickford, David; Tosun, Duygu; Satre, Derek D.; Gould, Christine E.; Nelson, J. Craig; Beaudreau, Sherry A.

doi:10.1016/j.jagp.2020.09.021

Cited by 6 publications

(10 citation statements)

References 7 publications

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“…Several studies showed an increased risk for suicidal behaviour with higher disability levels[ 20 , 22 , 40 , 42 , 47 , 48 ], poorer health status[ 22 , 39 ], and multimorbidity[ 41 , 47 ]. Almeida et al [ 2 ] studied the relationship of multiple clinical factors with suicide attempt and completed suicide among older men from Australia.…”

Section: Resultsmentioning

confidence: 99%

“…, ideation and attempting). Three studies tested psychological interventions[ 20 , 45 , 48 ], and three were focused on pharmacological interventions[ 43 , 46 , 55 ]; the study by Lohman et al [ 47 ] analysed the effects of a nursing-based intervention (the CAREPATH). On the other hand, the study by Szanto et al [ 51 ] included data from two primary trials on antidepressant treatments ( i.e.…”

Section: Resultsmentioning

confidence: 99%

“…The PATH yielded reductions in suicidal ideation during the course of treatment, in comparison to supportive therapy. On the other hand, Lutz et al [ 48 ] evaluated factors related to suicide ideation due to a psychological treatment delivery (12-wk problem-solving therapy). As a result, they found that the changes in functional disability derived from the intervention predicted the reductions in suicidal ideation.…”

Section: Resultsmentioning

confidence: 99%

“…Multimorbidity and poorer health status have been systematically associated with suicide behaviour symptoms across studies[ 2 , 41 , 47 ]. In the similar vein, disease burden and difficulties in activities of daily living have proven to put depressive older adults at higher risk of suicide behaviour, regardless of suicidality form[ 20 , 42 , 48 ]. Disability and chronic diseases have shown a main, independent association with suicide, apart from depression[ 76 , 77 ].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for suicidal behaviour in late-life depression: A systematic review

Fernandez-Rodrigues¹,

Sanchez-Carro²,

Lagunas³

et al. 2022

WJP

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BACKGROUND Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. AIM To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. METHODS A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms ( i.e. , wish to die, ideation, attempt, and completed suicide). RESULTS Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms. CONCLUSION To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for suicidal behaviour in late-life depression: A systematic review

Fernandez-Rodrigues¹,

Sanchez-Carro²,

Lagunas³

et al. 2022

WJP

View full text Add to dashboard Cite

show abstract

“…Psychotherapeutic interventions can effectively treat older adults’ depression (Cuijpers et al, 2020; Huang et al, 2015; Reynolds et al, 2022; see also American Psychological Association, 2014). The strongest evidence is for cognitive behavioral therapy (CBT), life review therapy, and problem-solving therapy (Jayasekara et al, 2015; Kanellopoulos et al, 2020; Lutz et al, 2021; Westerhof & Slatman, 2019). Most evidence on the effectiveness of psychotherapy for older adults with depression has come from samples of physically healthy, so-called “young–old” (55–75 years) home-living older adults (Cuijpers et al, 2014; Huang et al, 2015), or from samples of older adults living in long-term care facilities (Chan et al, 2021; Rabaioli-Fischer & Söder, 2021).…”

Section: Older Adults With Long-term Care Needs Rarely Participate In...mentioning

confidence: 99%

Psychotherapists’ experiences providing at-home psychotherapy for home-living older adults with long-term care needs and depression.

Demmerle¹,

Gellert²,

Kessler³

2023

Journal of Counseling Psychology

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This study used qualitative methods to explore psychotherapists' experiences conducting at-home psychotherapy with older adults (60+ years) with long-term care needs and depression. We conducted semistructured interviews with 16 female psychotherapists (26-70 years old) who delivered at-home cognitive behavioral therapy to home-living older adults with long-term care needs and depression. We additionally conducted 10 patient case studies. Using an adaption of the methodology of grounded theory, we iteratively developed a hierarchical model. Results showed that psychotherapists experienced three dilemmas: (a) pushing for change versus acknowledging limitations, (b) providing help versus maintaining boundaries, and (c) being a guest in the patient's home versus the host of a psychotherapy session. The absence of a shared understanding of therapy and confrontation with patients' existential suffering intensified the experience of the dilemmas. The dilemmas generated professional self-doubt and negative emotions, which in turn triggered a reflexive process and ultimately participants' professional development. Participants found a way to integrate drives initially perceived as mutually exclusive, and further developed their professional self-image and therapeutic techniques. We interpret the dilemmas as reflecting difficulty reconciling the "curing" and "caring" treatment paradigms. Practice and support managing the three dilemmas along with reflection on the curing paradigm, views on old age, and fear of existential suffering should be part of qualifications for psychotherapists working with older adults in need of care. Cooperating with other care providers may relieve the pressure on psychotherapists to provide forms of support that could lead to overburden and impede therapeutic progress. Public Significance StatementOur study provides unique insight into psychotherapists' experiences conducting at-home therapy with home-living older adults (60+ years) with long-term care needs and depression. Psychotherapists experienced three dilemmas reflecting difficulty balancing the goals of "curing" and "caring." Addressing these dilemmas in clinical training and supervision may help prepare psychotherapists to work with homeliving older adults with long-term care needs.

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Beyond maintaining safety: Examining the benefit of emotion-centered problem solving therapy added to safety planning for reducing late life suicide risk

Beaudreau

Lutz

Wetherell

et al. 2023

Contemporary Clinical Trials

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Improvements in Functional Disability After Psychotherapy for Depression Are Associated With Reduced Suicide Ideation Among Older Adults

Cited by 6 publications

References 7 publications

Risk factors for suicidal behaviour in late-life depression: A systematic review

Risk factors for suicidal behaviour in late-life depression: A systematic review

Psychotherapists’ experiences providing at-home psychotherapy for home-living older adults with long-term care needs and depression.

Beyond maintaining safety: Examining the benefit of emotion-centered problem solving therapy added to safety planning for reducing late life suicide risk

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