Differential psychological treatment effects in patients with late-life depression and a history of childhood maltreatment

Abstract: Objective
This is the first interventional study to assess the impact of childhood maltreatment (CM) on psychological treatment outcomes in patients with late-life depression (LLD).
Methods
This is a secondary analysis of a multicenter, randomized controlled trial with 251 participants aged ≥60 years with moderate to severe depression. Participants were randomly assigned to cognitive behavioral therapy for late life depression (LLD-CBT) or to a supportive intervention (SUI). Treatment outcomes were measured by changes in the Geriatric Depression Scale (GDS).
Results
In the intention-to-treat sample (n = 229), both LLD-CBT (n = 115) and SUI (n = 114) significantly reduced depressive symptoms in patients with CM, with large effects at post-treatment (d = 0.95 [95% CI: 0.65 to 1.25] in LLD-CBT; d = 0.82 [95% CI: 0.52 to 1.12] in SUI). A significant treatment group*CM interaction (F(1,201.31) = 4.71; p = .031) indicated greater depressive symptom reduction in LLD-CBT compared to SUI at week 5 and post-treatment for patients without CM, but not at 6-month follow-up. Across both treatments, higher severity of the CM subtype ‘physical neglect’ was associated with a smaller depressive symptom reduction (F(1,207.16) = 5.37; p = .021).
Conclusions
Specific and non-specific psychotherapy effectively reduced depressive symptoms in older individuals with depression and early trauma. For patients without early trauma, LLD-CBT may be preferable over SUI. Considering early trauma subtypes may contribute to develop personalized treatment approaches

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch
• Notes: American journal of geriatric psychiatry. - 32, 11 (2024) , 1325-1336, ISSN: 1545-7214

Contributors, Places and Time

• Event: Veröffentlichung
• (where): Freiburg
• (who): Universität
• (when): 2024
• Creator: Müller, Julia ; Elsaeßer, Moritz ; Müller, Wiebke ; Hellmich, Martin ; Hammen, Magdalena ; Zehender, Nadine ; Riedel-Heller, Steffi Gerlinde ; Bewernick, Bettina ; Wagner, Michael ; Frölich, Lutz ; Peters, Oliver ; Dafsari, Forugh Salimi ; Domschke, Katharina ; Jessen, Frank ; Hautzinger, Martin ; Schramm, Elisabeth

Further information

• DOI: 10.1016/j.jagp.2024.05.006
• URN: urn:nbn:de:bsz:25-freidok-2555875
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:32 AM CEST