Rollandi Isabel, Carter Emily, Banerjee Samprit, Culver Clare, Solomonov Nili, Sirey Jo Anne
Weill Cornell Institute of Geriatric Psychiatry (RI, BS, CC, SN, SJA), Weill Cornell Medicine, White Plains, NY.
Weill Cornell Department of Population Health (CE, BS), Weill Cornell Medicine, New York, NY.
Am J Geriatr Psychiatry. 2025 Jun;33(6):689-701. doi: 10.1016/j.jagp.2024.11.018. Epub 2024 Dec 2.
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.
Partner agencies referred depressed victims and received PROTECT for 10 weeks. Depression severity and SI were measured at each visit.
A sample of 158 depressed EA victims (PHQ-9 ≥ 10) without cognitive impairment (Tele-MoCA ≥ 11).
PROTECT is a behavioral psychotherapy delivered in 45-minute sessions in person or remotely (phone or video) for 10 weeks.
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.
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.
Suicidal ideation is equally prevalent across EA victims from different backgrounds. PROTECT can reduce depression and suicidal ideation in elder abuse victims.
尽管虐待老年人问题普遍存在，且常导致健康状况不佳和高死亡率，但该问题往往未得到解决。三分之一的受害者患有抑郁症。本研究旨在探讨：1）自杀意念（SI）是否与受害者的人口统计学特征或虐待特征相关；2）PROTECT心理治疗是否能减轻抑郁症，而不论是否有自杀意念；3）它是否能减少自杀意念。
合作机构转介了抑郁的受害者，并让他们接受为期10周的PROTECT治疗。每次就诊时测量抑郁严重程度和自杀意念。
158名无认知障碍（远程蒙特利尔认知评估量表≥11）的抑郁的虐待老年人受害者样本（患者健康问卷-9≥10）。
PROTECT是一种行为心理治疗，通过面对面或远程（电话或视频）进行45分钟的疗程，为期10周。
在基线时收集人口统计学和虐待情况的数据，每周收集抑郁严重程度（患者健康问卷-9）和自杀意念（患者健康问卷-9第9项）。我们使用混合效应模型研究对PROTECT的反应轨迹，以比较有自杀意念和无自杀意念参与者之间的反应以及整个治疗过程中自杀意念的变化。
受害者的人口统计学特征或虐待老年人特征与自杀意念之间没有关联。PROTECT导致抑郁严重程度总体降低：有自杀意念组在患者健康问卷-9上的估计平均改善为5.58分（95%置信区间：4.11，7.06），无自杀意念组改善了5.25分（95%置信区间：4.53，5.97）。随着时间的推移，自杀意念有所下降，19%的参与者在基线时认可有自杀意念，治疗结束时为5.7%。
不同背景的虐待老年人受害者中自杀意念的普遍程度相同。PROTECT可以减轻虐待老年人受害者的抑郁和自杀意念。
