@article{ref1,
title="Differential psychological treatment effects in patients with late-life depression and a history of childhood maltreatment",
journal="American journal of geriatric psychiatry",
year="2024",
author="Schramm, Elisabeth and Hautzinger, Martin and Jessen, Frank and Domschke, Katharina and Dafsari, Forugh S. and Peters, Oliver and Frolich, Lutz and Wagner, Michael and Bewernick, Bettina H. and Riedel-Heller, Steffi and Zehender, Nadine and Hammen, Magdalena and Hellmich, Martin and Müller, Wiebke and Elsaesser, Moritz and Müller, Julia",
volume="ePub",
number="ePub",
pages="ePub-ePub",
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). <br><br>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). <br><br>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). <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="1064-7481",
doi="10.1016/j.jagp.2024.05.006",
url="http://dx.doi.org/10.1016/j.jagp.2024.05.006"
}