CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom; MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom.
CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom; iCope - Camden and Islington Psychological Therapies Services - Camden & Islington NHS Foundation Trust, London, United Kingdom.
J Affect Disord. 2025 Jan 15;369:954-962. doi: 10.1016/j.jad.2024.10.098. Epub 2024 Oct 22.
Impairments in the ability to carry out social activities commonly co-occur alongside depression. Improving social functioning is often overlooked in treatment. This is despite the high value placed by patients on social functioning and the potential for interventions focused on social functioning to have additional benefits in reducing depressive symptoms. In older adults the relationship between depressive symptoms and social functioning during treatment is poorly understood.
We analysed data across the first four treatment sessions of 3260 older adults receiving psychological therapy for depression at eight NHS Talking Therapies for anxiety and depression services in England. Random-intercept cross-lagged panel models were estimated, modelling bi-directional change between depressive symptoms, and impairments in (a) social leisure activities, and (b) close relationships, controlling for gender and diagnosis.
Over treatment sessions, depressive symptoms and impairments in social functioning decreased. A bi-directional relationship was observed whereby depressive symptoms were associated with future impairments in social functioning and vice versa. Changes in depressive symptoms appeared to have a greater association with future social functioning, compared to the reverse.
Patients lived in Greater London and findings may not translate to other settings. We included older adults that attended at least four treatment sessions, and had no missing data at the first assessment, potentially biasing the sample and results.
Older adults receiving psychological therapy experience reductions in depressive symptoms and impairment in social functioning early in treatment. Treating core depressive symptoms and impairments in social functioning may benefit one another, and improve outcomes.
在患有抑郁症的人群中，社会活动能力受损通常会同时发生。在治疗中，改善社会功能往往被忽视。尽管患者非常重视社会功能，并且针对社会功能的干预措施有可能在减轻抑郁症状方面带来额外的益处，但情况仍然如此。在老年人中，治疗过程中抑郁症状与社会功能之间的关系尚未得到充分理解。
我们分析了英格兰 8 个 NHS 焦虑和抑郁治疗服务机构的 3260 名接受心理治疗的老年抑郁症患者在前四个治疗疗程中的数据。使用随机截距交叉滞后面板模型进行了估计，该模型对抑郁症状以及（a）社交休闲活动和（b）亲密关系中的功能障碍之间的双向变化进行建模，同时控制了性别和诊断。
在治疗过程中，抑郁症状和社会功能障碍均有所减轻。观察到一种双向关系，即抑郁症状与未来的社会功能障碍有关，反之亦然。与相反的情况相比，抑郁症状的变化似乎与未来的社会功能更相关。
患者居住在大伦敦地区，研究结果可能不适用于其他地区。我们纳入了至少参加四个疗程治疗且第一次评估时没有缺失数据的老年患者，这可能会使样本和结果产生偏差。
接受心理治疗的老年患者在治疗早期会经历抑郁症状和社会功能障碍的减轻。治疗核心抑郁症状和社会功能障碍可能会相互受益，并改善治疗结果。
