Centre for Emotional Health, School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
Centre for Ageing, Cognition and Wellbeing, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
PLoS One. 2022 Jun 27;17(6):e0269981. doi: 10.1371/journal.pone.0269981. eCollection 2022.
Increasing both the frequency and quality of social interactions within treatments for anxiety and depressive disorders in older adults may improve their mental health outcomes and quality of life. This study aims to evaluate the clinical efficacy and cost utility of an enhanced cognitive behavioural therapy (CBT) plus social participation program in a sample of older adults with depression and/or anxiety.
A total of 172 community-dwelling adults aged 65 years or older with an anxiety and/or depressive disorder will be randomly allocated to either an enhanced CBT plus social participation program (n = 86) or standard CBT (n = 86). Both treatments will be delivered during 12 weekly individual sessions utilising structured manuals and workbooks. Participants will be assessed at pre-treatment, post-treatment, and 12-month follow-up. The primary outcome evaluates mean change in clinician-rated diagnostic severity of anxiety and depressive disorders from baseline to post-treatment (primary endpoint) based on a semi-structured diagnostic interview. Secondary outcomes evaluate changes in symptomatology on self-report anxiety and depression measures, as well as changes in social/community participation, social network, and perceived social support, loneliness, quality of life, and use of health services. Economic benefits will be evaluated using a cost-utility analysis to derive the incremental cost utility ratios for the enhanced CBT program.
Outcomes from this study will provide support for the establishment of improved psychosocial treatment for older adults with anxiety and/or depression. Study outcomes will also provide health systems with a clear means to reduce the impact of poor emotional health in older age and its associated economic burden. In addition to the empirical validation of a novel treatment, the current study will contribute to the current understanding of the role of social participation in older adult wellbeing.
Prospectively registered on the Australian New Zealand Clinical Trials Registry (ID: ACTRN12619000242123; registered 19th February 2019) and the ISRCTN registry (ID: ISRCTN78951376; registered 10th July 2019).
在针对老年人焦虑和抑郁障碍的治疗中，增加社交互动的频率和质量，可能会改善他们的心理健康结果和生活质量。本研究旨在评估强化认知行为疗法（CBT）加社会参与方案在患有焦虑和/或抑郁的老年人群中的临床疗效和成本效用。
共有 172 名年龄在 65 岁及以上、患有焦虑和/或抑郁障碍的社区居住成年人将被随机分配到强化 CBT 加社会参与方案组（n=86）或标准 CBT 组（n=86）。两种治疗方法都将在 12 周的个人会议中使用结构化的手册和练习册进行。参与者将在治疗前、治疗后和 12 个月随访时进行评估。主要结局是根据半结构化诊断访谈，评估从基线到治疗后临床医生评定的焦虑和抑郁障碍严重程度的平均变化（主要终点）。次要结局评估自我报告的焦虑和抑郁测量的症状变化，以及社会/社区参与、社交网络和感知社会支持、孤独感、生活质量和卫生服务使用的变化。将使用成本效用分析评估经济效益，得出强化 CBT 方案的增量成本效用比。
本研究的结果将为老年焦虑和/或抑郁患者提供更好的心理社会治疗支持。研究结果还将为卫生系统提供一种明确的方法，以减轻老年人情绪健康状况不佳及其相关经济负担的影响。除了对新治疗方法的实证验证外，本研究还将有助于当前对社会参与在老年人群健康中的作用的理解。
前瞻性注册于澳大利亚和新西兰临床试验注册中心（ID：ACTRN12619000242123；注册于 2019 年 2 月 19 日）和 ISRCTN 注册中心（ID：ISRCTN78951376；注册于 2019 年 7 月 10 日）。
