Talk therapy may alleviate depression in people with dementia

Psychological treatments have been found to be worthwhile for people living with dementia and mental illness, a team of researchers have revealed.?

Medical studies have established that there is a bi-directional link between depression, anxiety, PTSD and dementia. Mental illness has been shown to directly cause dementia and to be an initial prodromal symptom or comorbid condition with dementia. Alternatively, in the other direction, dementia has the capacity to trigger a relapse of historic mental health issues.

Statistically, people with dementia are twice as likely as other people their age to be diagnosed with a major depressive disorder, and it has been estimated that 16% of people with dementia experience depression, but this may be as high as 40%. Therefore there is a great need to identify an effective treatment.

While it has been confirmed that neurological and psychological conditions are intimately connected, the most effective way to treat the associated emotional symptoms is currently undetermined. This is because various pharmacological treatments frequently used to treat mental illness are ineffective for people with dementia or negatively interact with the neurological condition and cause side effects.

‘The study has broken the stigma that psychological treatments are not effective for people living with dementia’

University College London (UCL) researchers reviewed the evidence from 29 trials of psychological treatments for people with dementia or mild cognitive impairments, including close to 2,600 study participants in total. The psychological interventions analysed varied, ranging from CBT to supportive counselling interventions.

The review showed that psychological treatments for people with dementia may improve not only symptoms of depression but several other outcomes, such as quality of life and the ability to carry out everyday activities. Although the authors said more research is needed, the study found that these treatments could also improve depression remission.

Co-author Dr Phuong Leung, UCL Psychiatry, said:

“There is now good enough quality evidence to support the use of psychological treatments for people with dementia, rather than prescribing medications, and without the risk of drug side effects. What we need now is more clinicians opting for talk therapies for their patients and commitment to funding further high-quality research in this area.”

Lead author Dr Vasiliki Orgeta, Associate Professor at UCL Psychiatry, added:

“We currently have no standard treatments for depression for people with dementia, as antidepressants do not work for them. Yet, despite the lack of supporting evidence, they are still prescribed for many people living with dementia, which is an important problem given that more and more evidence is accumulating suggesting that not only they do not improve symptoms, but they may increase [the] risk of mortality.”

“Previous evidence into the clinical effectiveness of psychological treatments has been limited. Reporting on the most up to date evidence, we found that these treatments, and specifically those focusing around supporting people with dementia to use strategies to reduce distress and improve wellbeing, are effective in reducing symptoms of depression.”