A Pilot Randomised Controlled Trial Examining the Feasibility, Acceptability and Potential Efficacy of Transdiagnostic CBT for Depression and Anxiety in Older People.

Abstract

Introduction: Anxiety and depression represent a common problem in
later life and a growing challenge to society as the proportion of older
people continues to rise. Despite this, the efficacy of evidence-based
treatments to treat these disorders in older people has received little
attention compared to working-age and youth populations. The
current study examined the preliminary outcomes, feasibility and
acceptability of a 12-session transdiagnostic Cognitive Behaviour
Therapy (tCBT) intervention for older adults with symptoms of anxiety
and depression.

Methods: 16 older adults (aged 60 and above) were randomised to
either an immediate (n=8) or 7-week delayed tCBT treatment
condition (n=8). Change scores on the HADS (Hospital Anxiety and
Depression Scale) and CORE-10 (Clinical Outcomes of Routine
Evaluation-10) were used to evaluate efficacy; rates of attrition due to
practical reasons were used to evaluate the feasibility of the
intervention; and rates of attrition due to treatment dissatisfaction,
homework compliance and feedback from a Discharge Satisfaction
Questionnaire were used to evaluate the acceptability of the
intervention.

Results: Significant reductions in self-reported symptoms of anxiety
and depression were reported pre- to post-treatment. Seventy-one
percent of participants were classifiable as ‘reliably improved’ (n=10)
and 64% as ‘recovered’ (n=9) in terms of their depression symptoms.
Forty-three percent of participants were classifiable as ‘reliably
improved’ (n=6) and 36% (n=5) as ‘recovered’ in terms of their anxiety
symptoms following the intervention. Significant between-group
differences were found in terms depression, but not anxiety
symptoms. Satisfaction with the intervention and homework
compliance was high, whilst rates of attrition low (n=3).

Discussion: Preliminary data suggest that this burgeoning approach
can produce efficacious outcomes for older people with comorbid
emotional disorders, and it is both feasible and acceptable to apply
tCBT interventions to older people. tCBT has the potential to address
some of the shortcomings of disorder-specific CBT, through offering a
more clinically and time-efficient approach to comorbidity and
enabling much-needed improvements to the dissemination of and
access to evidence-based psychological therapies for older people.

Date of Award	2014
Original language	English
Awarding Institution	King's College London
Supervisor	Rebecca Gould (Supervisor)