Trust plays key role in study into innovative treatment for depression in older people

23 Feb 17

The Trust has played a key role in a clinical trial into an innovative psychological treatment which can help older people who are suffering from lower-severity depression and prevent more severe depression from developing.

The CASPER study, led by researchers at York University, in partnership with clinical academics from TEWV NHS FT, is the largest-ever study of its kind and included participants from Newcastle, Durham, York and Leeds.

Depression is common amongst older people, with one in seven meeting the criteria for full-blown depression. Older people at the greatest risk of depression are those who suffer from loneliness and long-term illnesses, both of which affect this age group disproportionately.

Being depressed can also make health problems worse and older people with depression are at an increased risk of dying. The CASPER clinical trial focussed on older people with lower-severity symptoms who are at the highest risk of becoming clinically depressed.

The CASPER study showed that a simple and low-cost intervention reduced the symptoms of depression in older people (aged 65 and over). The intervention consisted of 6-8 telephone or face to face contacts, lasting about 20 minutes each.

Those who received the intervention were also less likely to be more severely depressed after a year. Older people were also less anxious and had improved quality of life compared to people who just received care from their GP. 

Study manager, Kate Bosanquet, from the University of York’s Department of Health Sciences said: “We developed our Collaborative Care intervention after consulting with older people and considering evidence about effective treatments for depression.”

Co-investigator Dr David Ekers, a nurse consultant from TEWV and senior visiting research fellow at the University of York, Department of Health Sciences said: “We used a simple psychological approach called behavioural activation to support older adults in this study. Using the approach they were guided to re-engage with healthy activities that they could do and find alternatives to those things that were no longer possible. This is important to help people deal with the symptoms they had and stay well.

“Staff from Talking Changes improving access to psychological therapies (IAPT) provided the clinical input for the study locally and were central to the success of the project. TEWV has supported the development of Behavioural Activation research over a period of 10 years which is now having a major impact on the delivery of psychological interventions for depression”.

Older people taking part in the trial found Collaborative Care to be an acceptable way of accessing help, and by mostly working with people over the telephone, an approach that participants appreciated, it meant they did not have to travel to hospital to receive psychological care.

The study team, which also included researchers from the NHS, other universities and the Hull York Medical School are now planning to train NHS therapists in Collaborative Care to ensure that older people all over the UK can benefit from this intervention.

Chief Investigator, Professor Simon Gilbody said: “This is the largest rigorous study of its kind and we are very grateful to the National Institute for Health Research, which funded our work, and to the hundreds of people who participated in the study

“There is currently very little in the way of psychological treatment offered for older people. We hope that our research will improve the lives of older people throughout the UK.”

The study is reported in the Journal of the American Medical Association (JAMA).