None listed
Conditions
Brief summary
Anxiety and depressive disorders, which frequently co-occur, are the most common mental disorders in older adults (Beekman et al., 2000; Sunderland et al., 2015). The co-occurrence of anxiety and depression in older adults is associated with worse outcomes than either disorder alone, including increased risk of cognitive decline and dementia (de Beurs et al., 2009; Paterniti et al., 2002; Wetherell et al., 2004). Anxiety and depression can be successfully treated in community-dwelling older adults using psychological interventions, with the strongest evidence for cognitive behavioural therapy (CBT) (Wuthrich et al., 2021). When symptoms cannot be managed in the community or when individuals are at risk of self- harm, older adults are managed in inpatient wards. With the population rate of overnight mental health-related hospital stays for older Australians increased by a striking 82.4%, from 2006–07 to 2018–19 (Australian Institute of Health and Welfare, 2020), more needs to be done to assist older adults in inpatient wards. However, there are no evidence-based psychological interventions in inpatient settings that target anxiety and depression in older adults. Instead, psychotropics are used, including benzodiazepines which increases risk of falls and cognitive decline. Therefore, interventions developed using evidence- based practice that are feasible in this challenging setting are needed. Challenges to psychological management include disorientation of patients in these settings, variable attendance, and admission durations. Therefore, this project brings together experts in older adult mental health across multiple disciplines (clinical psychology, biostatistics, primary care) with clinical practitioners in inpatient services to co-design a group therapy intervention and evaluation procedure.
Interventions
Participants will engage in an inpatient group psychological program designed to reduce depression and anxiety in older adults who are currently staying in hospital. The program consists of eight one-hour modules designed to be delivered weekly.
Treatment modules include psychoeducation, mood monitoring, pleasant event scheduling, physical exercise scheduling, problem solving, thought restructuring, communication strategies, and sleep hygiene.
Modules are presented in face-to-face group sessi
Participants will engage in an inpatient group psychological program designed to reduce depression and anxiety in older adults who are currently staying in hospital. The program consists of eight one-hour modules designed to be delivered weekly. Treatment modules include psychoeducation, mood monitoring, pleasant event scheduling, physical exercise scheduling, problem solving, thought restructuring, communication strategies, and sleep hygiene. Modules are presented in face-to-face group sessions facilitated by a therapist. Activities such as identifying symptoms of anxiety and low mood are completed during a session. Participants are encouraged to practise skills covered in the treatment modules outside of group sessions. The approximate size of the groups will be groups of 3-4. Adherence to the intervention will be monitored using session attendance checklists.
Sponsors
Macquarie University
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Aged 65 years or older; anxiety and/or depression is the main interfering problem according to the inpatient service intake assessment; has capacity to provide informed consent for participation. Participants must be an inpatient in one of the participating hospitals (Greenwich or Braeside Hospitals). The participant will also have sufficient English literacy.
Exclusion criteria
English language illiteracy, current psychotic or manic episode, drug/alcohol dependence, significant uncorrected hearing loss and likely moderate to severe dementia based as assessed by clinical staff. Co-morbidity with other psychiatric diagnose (with the exception of psychotic or bipolar disorder) is allowed in order to establish a clinically relevant, broadly representative sample. Patients who are currently receiving care under the Mental Health Act may be eligible to participate when their status change to voluntary patients.
Outcome results
None listed