TY - JOUR
T1 - Cognitive behavioural therapy for depression, anxiety and stress in caregivers of dementia patients
T2 - a systematic review and meta-analysis
AU - Hopkinson, Michael
AU - Reavell, James
AU - Lane, Deirdre
AU - Mallikarjun, Pavan
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background and Objectives
There is limited evidence for the efficacy of cognitive behavioral therapy (CBT) in managing psychological morbidities in caregivers of dementia patients. To evaluate changes in dementia caregivers’ depression, anxiety, and stress following CBT. Also to assess quality of life, intervention adherence/satisfaction and therapy effectiveness using different formats, frequencies, and delivery methods.
Research Design and Methods
Studies were identified through electronic bibliographic searches (MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Library) and from gray literature (Conference Proceedings Citation Index and clinicaltrials.gov). Data were pooled for meta-analysis.
Results
Twenty-five studies were included. Depression (standardized mean difference [SMD] = −0.34; 95% confidence interval [CI] −0.47 to −0.21; p < .001) and stress (SMD = −0.36; 95% CI: −0.52 to −0.20; p < .001) were significantly reduced after CBT, relative to comparator groups, while anxiety was not (SMD = 0.10; 95% CI: −0.18 to 0.39; p = .47). A subgroup analysis demonstrated that statistically significant reductions in depression and stress were limited to group, but not individual, formats. An additional subgroup analysis revealed that eight CBT sessions or fewer were equally effective as more than eight sessions at significantly reducing depression and stress, relative to comparator groups. Furthermore, analysis with independent samples t-tests demonstrated no statistically significant differences between mean changes in depression (MD = 0.79; 95% CI: −0.45 to 2.03; p = .21) and stress (MD = 0.21; 95% CI: −1.43 to 1.85; p = .80) when directly comparing CBT groups of ≤8 and >8 sessions.
Discussion and Implications
Group CBT provides small but significant benefits to caregivers’ depression and stress. Therapy cost-effectiveness may be improved by limiting therapy to group formats and eight sessions.
AB - Background and Objectives
There is limited evidence for the efficacy of cognitive behavioral therapy (CBT) in managing psychological morbidities in caregivers of dementia patients. To evaluate changes in dementia caregivers’ depression, anxiety, and stress following CBT. Also to assess quality of life, intervention adherence/satisfaction and therapy effectiveness using different formats, frequencies, and delivery methods.
Research Design and Methods
Studies were identified through electronic bibliographic searches (MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Library) and from gray literature (Conference Proceedings Citation Index and clinicaltrials.gov). Data were pooled for meta-analysis.
Results
Twenty-five studies were included. Depression (standardized mean difference [SMD] = −0.34; 95% confidence interval [CI] −0.47 to −0.21; p < .001) and stress (SMD = −0.36; 95% CI: −0.52 to −0.20; p < .001) were significantly reduced after CBT, relative to comparator groups, while anxiety was not (SMD = 0.10; 95% CI: −0.18 to 0.39; p = .47). A subgroup analysis demonstrated that statistically significant reductions in depression and stress were limited to group, but not individual, formats. An additional subgroup analysis revealed that eight CBT sessions or fewer were equally effective as more than eight sessions at significantly reducing depression and stress, relative to comparator groups. Furthermore, analysis with independent samples t-tests demonstrated no statistically significant differences between mean changes in depression (MD = 0.79; 95% CI: −0.45 to 2.03; p = .21) and stress (MD = 0.21; 95% CI: −1.43 to 1.85; p = .80) when directly comparing CBT groups of ≤8 and >8 sessions.
Discussion and Implications
Group CBT provides small but significant benefits to caregivers’ depression and stress. Therapy cost-effectiveness may be improved by limiting therapy to group formats and eight sessions.
KW - Alzheimer’s disease
KW - Mental health
KW - Psychotherapy
UR - http://www.scopus.com/inward/record.url?scp=85069872593&partnerID=8YFLogxK
U2 - 10.1093/geront/gnx217
DO - 10.1093/geront/gnx217
M3 - Article
SN - 0016-9013
VL - 59
SP - e343–e362
JO - The Gerontologist
JF - The Gerontologist
IS - 4
ER -