Behavioral Activation for the Prevention and Treatment of Depression in Older Adults in a Municipal Context

NCT ID: NCT06415838

Last Updated: 2024-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-27

Study Completion Date

2026-08-31

Brief Summary

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The goal of this randomized clinical trial is to investigate if a brief psychological treatment called Behavioral Activation (BA) works to prevent and treat depression in older adults in a municipal context in Sweden. It will also learn about the patients' and therapists' experiences of the BA-treatment.

The main questions it aims to answer are if the BA-treatment has an effect on the short and long term on:

* Depressive symptoms
* Anxiety symptoms
* Self-rated activation
* Functional ability
* Loneliness
* Self efficacy
* Mental wellbeing
* Quality of life
* Need for community care services

All participants will continue their care as usual (CAU), and half of the participants will be randomized to receive a five-session BA-treatment spread over two months as an add-on to CAU. All participants will answer a questionnaire in the beginning of the study, after two months, and after 3-, 6- and 12 months.

Detailed Description

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One third of the Swedish population aged 70 years and above report depressive symptoms, and between 5 - 15% have a major depressive disorder. Depression in older adults reduces quality of life and functional ability, and is associated with an increased risk for morbidity and mortality. Psychological treatment is considered a first-line treatment for depression, but is currently only offered to about 3% of older adults with depression in Sweden. A majority of older adults suffering from depression in Sweden are likely not to be identified and diagnosed, and thereby not treated for their depression. Furthermore, many older adults receive municipal care, and psychological treatment is currently not available in this context.

The goal of this randomized clinical trial is to investigate if a brief psychological treatment called Behavioral Activation (BA) works to prevent and treat depression in older adults in a municipal context in Sweden. It will also learn about the patients' and therapists' experiences of the BA-treatment. The therapists in the trial are social workers working in Eskilstuna municipality in Sweden.

All participants will continue their care as usual (CAU), and half of the participants will be randomized to receive a five-session BA-treatment spread over two months as an add-on to CAU. The BA-treatment will be delivered in the participants' home. All participants will answer a questionnaire in the beginning of the study, after two months, and after 3-, 6- and 12 months.

The main questions that the trial aims to answer are if the BA-treatment has an effect on the short and long term on:

* Depressive symptoms
* Anxiety symptoms
* Self-rated activation
* Functional ability
* Loneliness
* Self efficacy
* Mental wellbeing
* Quality of life
* Need for community care services

Conditions

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Depression Depressive Symptoms

Keywords

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Behavioral activation Behavior therapy Psychological treatment Older adults Geriatric

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Brief Behavioral Activation plus Care as Usual

Five-session Brief Behavioral Activation intervention. Sessions 1 - 4 are completed once a week, and session 5 is a booster-session completed four weeks after session 4.

Group Type EXPERIMENTAL

Brief Behavioral Activation

Intervention Type BEHAVIORAL

A five-session brief behavioral activation treatment delivered face-to-face in the participants' home.

Session outline:

Session 1: Psychoeducation about depression; treatment rationale for Behavioral Activation (BA); rationale and instructions for activity log

Session 2: Discussion of life goals and values; planning of activities aligned with life goals and values for coming week

Session 3: Troubleshooting any problems carrying out activities; planning activities aligned with life goals and values for coming week.

Session 4: Troubleshooting any problems carrying out activities; planning activities aligned with life goals and values for the coming week; instructing the participant to independently continue to plan activities for the coming month.

Session 5: Troubleshooting any problems carrying out activities; reviewing treatment; stressing the importance of continuing to engage in activities aligned with life goals and values; creating a maintenance plan.

Care as Usual

Intervention Type OTHER

Care as Usual provided by primary care and/or municipal care.

Care as Usual

Care as usual as provided by primary care and/or municipal care.

Group Type ACTIVE_COMPARATOR

Care as Usual

Intervention Type OTHER

Care as Usual provided by primary care and/or municipal care.

Interventions

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Brief Behavioral Activation

A five-session brief behavioral activation treatment delivered face-to-face in the participants' home.

Session outline:

Session 1: Psychoeducation about depression; treatment rationale for Behavioral Activation (BA); rationale and instructions for activity log

Session 2: Discussion of life goals and values; planning of activities aligned with life goals and values for coming week

Session 3: Troubleshooting any problems carrying out activities; planning activities aligned with life goals and values for coming week.

Session 4: Troubleshooting any problems carrying out activities; planning activities aligned with life goals and values for the coming week; instructing the participant to independently continue to plan activities for the coming month.

Session 5: Troubleshooting any problems carrying out activities; reviewing treatment; stressing the importance of continuing to engage in activities aligned with life goals and values; creating a maintenance plan.

Intervention Type BEHAVIORAL

Care as Usual

Care as Usual provided by primary care and/or municipal care.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 65 years or older
* 5 points or above on the Geriatric Depression Scale 15, GDS-15
* Fluent in written and spoken Swedish
* Consents to participate in the trial

Exclusion Criteria

* Not able to use the patient materials due to visual impairment
* Not able to communicate with therapist due to hearing impairment
* Diagnosis of major neurocognitive disorder
* Below 25 points on the Mini Mental State Examination, MMSE
* Elevated suicide risk
* Current substance- or alcohol use disorder
* Previous or current psychotic disorder
* Previous or current bipolar disorder
* Ongoing psychological treatment/pscyhotherapy
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eskilstuna municipality

UNKNOWN

Sponsor Role collaborator

Sormland County Council, Sweden

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Johnny Pellas, PhD

Role: PRINCIPAL_INVESTIGATOR

Research and Development Sormland

Locations

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Eskilstuna kommun

Eskilstuna, Sörmland, Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Johnny Pellas, PhD

Role: CONTACT

Phone: +46702319795

Email: [email protected]

Marina Arkkukangas, PhD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Johnny Pellas, PhD

Role: primary

Other Identifiers

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DePrevent

Identifier Type: -

Identifier Source: org_study_id