TOPLINE:
Weekly telephone calls to seniors offering motivation and support may reduce their symptoms of depression and help them feel less lonely, a new study showed.
METHODOLOGY:
- As part of the Behavior Activation in Social Isolation trial, 435 participants (62% female; 96% White individuals) aged 65 and older with multiple long-term health conditions were recruited from general medical practices in England and Wales.
- Eligible participants, 46% of whom lived alone, followed COVID-19 protocols to socially isolate and were at high risk of loneliness and depression (score of ≥ 5 on the Patient Health Questionnaire-9 [PHQ-9]).
- Participants received up to eight weekly sessions of either a phone-based structured psychotherapy called behavioral action to increase engagement with rewarding activities and decrease those that maintain depression (intervention group; n = 218) or usual care, with information about self-help and advice on how to stay well mentally and physically (control group, n = 218).
TAKEAWAY:
- While mean PHQ-9 scores decreased in both groups over the length of the study, the decrease was larger in the intervention group at 3 months (adjusted mean difference between groups, −1.65; P = .0003).
- The effect was largest among those scoring ≥ 10 on the PHQ-9 at baseline (mean difference at ≥ 10 weeks, −2.48; P = .0002 vs mean difference at 5-9 on the PHQ-9 at baseline, −1.13; P = .051).
- Those who received the intervention experienced less emotional loneliness measured on the De Jong Gierveld Loneliness Scale than those in the control group at the 3-month mark (adjusted mean difference, −0.37; P = .018).
IN PRACTICE:
" Looking to the future, behavioral activation could be used to mitigate depression and the risk of loneliness in the presence of shocks to health systems and populations, such as future pandemics or other shocks that could increase anxiety and depression among vulnerable groups, such as the climate emergency," the authors wrote.
SOURCE:
Simon Gilbody, DSc, FMedSci, of the University of York in York, United Kingdom, and David Ekers, PhD, of Tees, Esk and Wear Valleys National Health Service Foundation Trust in Middlesborough, United Kingdom, co-led the study, which was published online in the February 2024 Lancet Healthy Longevity.
LIMITATIONS:
Trial participants were not masked as to which intervention they received, and the sample included mostly White individuals, which restricts generalization to more diverse populations.
DISCLOSURES:
The study was funded by the National Institute for Health Care and Research. Gilbody and Elkers are members of the NICE Depression Guideline (update) Development Group.