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Psychological Interventions in Older Adults

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Primary Care Mental Health in Older People

Abstract

As older adults grow increasingly dependent on their adult children, family roles shift, and multiple unfamiliar demands are placed on caregivers, which puts older adults and caregivers at increased risk for mental illness. When older adults are able to overcome barriers to accessing mental health services (e.g. stigma), psychological therapies are effective when used on their own or in combination with psychotropic medication. This chapter describes a variety of psychological therapies for older adults coping with depression, anxiety, dementia/cognitively impaired disorders, and personality disorders. In addition, numerous resources are offered to help older adults and their family members clarify the necessary changes that must be made to cope with losses and preserve meaning and hope. The chapter highlights several ways to deliver care, including upskilling of existing primary care staff, stepped care, collaborative care, and referral to a mental health specialist in the community.

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References

  1. Forsman AK, Nordmyr J, Wahlbeck K. Psychosocial interventions for the promotion of mental health and the prevention of depression among older adults. Health Promot Int. 2011;26:85–107.

    Article  Google Scholar 

  2. Givens J, et al. Older patients’ aversion to antidepressants: a qualitative study. J Gen Intern Med. 2006;21:146–51.

    PubMed  PubMed Central  Google Scholar 

  3. Wilkinson P. Psychological treatments. In: Oxford textbook of old age psychiatry. 2nd ed. New York: Oxford University Press; 2013.

    Google Scholar 

  4. Gallagher-Thompson D, Thompson L. Treating late-life depression: a cognitive-behavioural approach, therapist’s guide. New York: Oxford University Press; 2010.

    Google Scholar 

  5. Beekman AT, Copeland JR, Prince MJ. Review of community prevalence of depression in later life. Br J Psychiatry. 1999;174:307–11.

    Article  CAS  Google Scholar 

  6. Bryant C, Jackson H, Ames D. The prevalence of anxiety in older adults: methodological issues and a review of the literature. J Affect Disord. 2008;109:233–50.

    Article  Google Scholar 

  7. Prina AM, et al. Prevalence of anxiety and its correlates among older adults in Latin America, India and China: cross-cultural study. Br J Psychiatry. 2011;199:485–91.

    Article  Google Scholar 

  8. Lam TP, et al. Proposed new diagnoses of anxious depression and bodily stress syndrome in ICD-11-PHC: an international focus group study. Fam Pract. 2013;30:76–87.

    Article  CAS  Google Scholar 

  9. Löwe B, et al. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. Gen Hosp Psychiatry. 2008;30:191–9.

    Article  Google Scholar 

  10. Andreescu C, Reynolds CF. Late-life depression: evidence-based treatment and promising new directions for research and clinical practice. Psychiatr Clin N Am. 2011;34:335–55.

    Article  Google Scholar 

  11. Miller MD, Morse J. Psychotherapeutic approaches for depression, cognitive impairment, and personality disorders in late-life. In: Geriatric psychiatry. New York: Oxford University Press; 2013.

    Chapter  Google Scholar 

  12. Ayers CR, et al. Evidence-based psychological treatments for late-life anxiety. Psychol Aging. 2007;22:8–17.

    Article  Google Scholar 

  13. DeBerry S, Davis S, Reinhard KE. A comparison of meditation relaxation and cognitive/behavioural techniques for reducing anxiety and depression in a geriatric population. J Geriatr Psychiatry. 1989;22:231–47.

    CAS  PubMed  Google Scholar 

  14. National Collaborating Centre for Mental Health. Depression. The NICE guideline on the treatment and management of depression in adults (updated edition), National clinical practice guideline 90. London: British Psychological Society/Royal College of Psychiatrists; 2010.

    Google Scholar 

  15. New Zealand Guidelines Group. Identification of common mental disorders and management of depression in primary care. Wellington: New Zealand Guidelines Group; 2008.

    Google Scholar 

  16. Dowell A, Morris C, Dodds T, McLoughlin B. Psychological interventions in primary care mental health. In: Companion to primary care mental health. London: Radcliffe Publishing; 2012.

    Google Scholar 

  17. National Collaborating Centre for Mental Health. Depression. The NICE guideline on the treatment and management of depression in adults (partial update of NICE clinical guideline 23), National clinical practice guideline 90. London: British Psychological Society/Royal College of Psychiatrists; 2009.

    Google Scholar 

  18. Bridle C. Effect of exercise on depression severity in older adults: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry. 2012;201:180–5.

    Article  Google Scholar 

  19. Mead N, et al. Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis. Br J Psychiatry. 2010;196:96–101.

    Article  Google Scholar 

  20. Kerse N, et al. Home-based activity program for older people with depressive symptoms (DeLLITE), a randomized controlled trial. Ann Fam Med. 2010;8:214–23.

    Article  Google Scholar 

  21. Grant RW, Casey DA. Adapting cognitive behavioural therapy for the frail elderly. Int Psychogeriatr. 1995;7:561–71.

    Article  CAS  Google Scholar 

  22. Alexopoulos GS, et al. Problem solving therapy and supportive therapy in older adults with major depression and executive dysfunction. Arch Gen Psychiatry. 2011;68:32–41.

    Article  Google Scholar 

  23. Dowell AC, et al. Evaluation of the primary mental health initiatives: summary report. Wellington: University of Otago and Ministry of Health; 2009.

    Google Scholar 

  24. Gould RL, Coulson MC, Howard RJ. Cognitive behavioral therapy for depression in older people: a meta-analysis and meta-regression of randomized controlled trials. J Am Geriatr Soc. 2012;60:1817–30.

    Article  Google Scholar 

  25. Gould RL, Coulson MC, Howard RJ. Efficacy of cognitive behavioral therapy for anxiety disorders in older people: a meta-analysis and meta-regression of randomized controlled trials. J Am Geriatr Soc. 2012;60:218–29.

    Article  Google Scholar 

  26. Weissman MM, Markowitz JC, Kierman GL. Comprehensive guide to interpersonal psychotherapy. New York: Basic Books; 2000.

    Google Scholar 

  27. Miller MD. Clinician’s guide to interpersonal psychotherapy in late-life: helping cognitively impaired or depressed elders and their care-givers. New York: Oxford University Press; 2009.

    Book  Google Scholar 

  28. Serrano JP, et al. Life review therapy using autobiographical retrieval practice for older adults with depressive symptomatology. Psychol Aging. 2004;19:272–7.

    Article  Google Scholar 

  29. Arean PA. Comparative effectiveness of social problem-solving therapy and reminiscence therapy as treatments for depression in older adults. J Consult Clin Psychol. 1993;61:1003–10.

    Article  CAS  Google Scholar 

  30. Lynch TR, Epstein DE, Smoski MJ. Individual and group psychotherapy. In: Clinical manual of geriatric psychiatry. Washington: American Psychiatric Publishing; 2014.

    Google Scholar 

  31. Hall GR, Buckwalker KC. Progressively lowered stress threshold: a conceptual model for care of adults with Alzheimer’s disease. Arch Psychiatr Nurs. 1987;1:399–406.

    CAS  PubMed  Google Scholar 

  32. Gerdner LA, Buckwalter KC, Reed D. Impact of a psycho-educational intervention on caregiver response to behavioural problems. Nurs Res. 2002;51:363–74.

    Article  Google Scholar 

  33. Abrams RC. Personality disorders in the elderly. Int J Geriatr Psychiatry. 1996;11:759–63.

    Article  Google Scholar 

  34. Torgersen S, Kringlen E, Cramer V. The prevalence of personality disorders in a community sample. Arch Gen Psychiatry. 2001;58:590–6.

    Article  CAS  Google Scholar 

  35. Reiss D, Steinglass P, Howe G. The family’s organization around the illness. In: How do families cope with chronic illness? Hillsdale, NJ: Lawrence Erlbaum; 1993.

    Google Scholar 

  36. Gawande A. Being mortal. New York: Metropolitan Books; 2014.

    Google Scholar 

  37. Qualls S, Williams A. Caregiver family therapy: empowering families to meet the challenges of aging. Washington, DC: American Psychological Association; 2013.

    Book  Google Scholar 

  38. Gilbody S, et al. Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166:2314–21.

    Article  Google Scholar 

  39. Unützer J, et al. Collaborative-care management of late-life depression in the primary care setting. J Am Med Assoc. 2002;288:2836–45.

    Article  Google Scholar 

  40. Alexopoulos GS, et al. Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the PROSPECT study. Am J Psychiatr. 2009;166:882–90.

    Article  Google Scholar 

  41. Gallo JJ, et al. The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Ann Intern Med. 2007;146:689–98.

    Article  Google Scholar 

  42. Andrews G. http://www.australianageingagenda.com.au/2014/07/18/elderly-succeed-internet-depression-treatment/.

  43. Dear BF, et al. Internet-delivered cognitive behavioural therapy for depression: a feasibility open trial for older adults. Aust N Z J Psychiatry. 2013;47:169–76.

    Article  Google Scholar 

  44. Alexander CL, et al. Bringing psychotherapy to primary care: innovations and challenges. Clin Psychol Sci Pract. 2010;17:191–214.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Marital and Family Therapy Program, University of San Diego, San Diego, CA, USA

    Todd M. Edwards & Jo Ellen Patterson

  2. Obstetrics and Gynecology, University of Otago Wellington University of Otago, Wellington, New Zealand

    Anthony Dowell

  3. Center for Ethics, Oregon Health & Science University, Portland, OR, USA

    David Clarke

  4. Gastroenterology, Oregon Health & Science University, Portland, OR, USA

    David Clarke

  5. Masina Hospital, Mumbai, India

    Vinodkumar R. Gangolli

  6. Grand River Hospital, Kitchener, ON, Canada

    Vinodkumar R. Gangolli

  7. Department of Psychiatry and Neuro-Behavioral Sciences, McMaster’s University, Hamilton, ON, Canada

    Vinodkumar R. Gangolli

Authors
  1. Todd M. Edwards
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  2. Anthony Dowell
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  3. David Clarke
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  4. Vinodkumar R. Gangolli
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  5. Jo Ellen Patterson
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Corresponding author

Correspondence to Todd M. Edwards .

Editor information

Editors and Affiliations

  1. Unité de Psychiatrie et de Psychothérapie, Centre Les Toises, Lausanne, Switzerland

    Carlos Augusto de Mendonça Lima

  2. Mental Health and Population Health, NOVA University Lisbon, Lisbon, Portugal

    Gabriel Ivbijaro

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Edwards, T.M., Dowell, A., Clarke, D., Gangolli, V.R., Patterson, J.E. (2019). Psychological Interventions in Older Adults. In: de Mendonça Lima, C., Ivbijaro, G. (eds) Primary Care Mental Health in Older People. Springer, Cham. https://doi.org/10.1007/978-3-030-10814-4_10

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  • DOI: https://doi.org/10.1007/978-3-030-10814-4_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10812-0

  • Online ISBN: 978-3-030-10814-4

  • eBook Packages: MedicineMedicine (R0)

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