Reducing Depression and Suicidal Ideation Among Elder Abuse Victims Using PROTECT.

OBJECTIVE

Elder abuse is prevalent and often unaddressed despite poor health and high mortality outcomes. One third of victims suffer from depression. This study examined whether: 1) suicidal ideation (SI) is associated with victims' demographic or abuse characteristics; 2) PROTECT psychotherapy reduces depression regardless of suicidal ideation; and 3) it reduces suicidal ideation.

DESIGN

Partner agencies referred depressed victims and received PROTECT for 10 weeks. Depression severity and SI were measured at each visit.

PARTICIPANTS

A sample of 158 depressed EA victims (PHQ-9 ≥ 10) without cognitive impairment (Tele-MoCA ≥ 11).

INTERVENTION

PROTECT is a behavioral psychotherapy delivered in 45-minute sessions in person or remotely (phone or video) for 10 weeks.

MEASURES

Data on demographics and abuse were collected at baseline, and depression severity (PHQ-9) and SI (PHQ-9 item 9) weekly. We examined trajectories of response to PROTECT with mixed-effects models to compare response among SI and Non-SI participants and change in SI throughout treatment.

RESULTS

There was no association between victims' demographic or elder abuse characteristics and SI. PROTECT led to overall reduction in depression severity: the SI group showed an estimated mean improvement of 5.58 points on the PHQ-9 (95% CI: 4.11, 7.06), and non-SI group improved by 5.25 (95% CI: 4.53, 5.97) points. SI decreased over time, with 19% of participants endorsing SI at baseline and 5.7% at end of treatment.

CONCLUSIONS

Suicidal ideation is equally prevalent across EA victims from different backgrounds. PROTECT can reduce depression and suicidal ideation in elder abuse victims.