Ignite Creation Date:
2024-05-06 @ 7:31 PM
Last Modification Date:
2024-10-26 @ 3:08 PM
Study NCT ID:
NCT06042283
Status:
NOT_YET_RECRUITING
Last Update Posted:
2023-09-21
First Post:
2023-08-15
Brief Title:
Efficacy of Metacognitive Training in Older Adults With Depression
Sponsor:
Istanbul University - Cerrahpasa IUC
Organization:
Istanbul University - Cerrahpasa IUC
Study Overview
Official Title:
Assessing the Efficacy of Metacognitive Training on Depressive Symptoms Dysfunctional Attitudes and Metacognition in Older Adults Diagnosed With Depression
Status:
NOT_YET_RECRUITING
Status Verified Date:
2023-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Effective pharmacological and psychological treatments for depression are available However treatment modalities are not accessible to all patients diagnosed with depression Furthermore some individuals who access treatment drop out and relapse after treatment Improving treatment modalities for depression is important given the rates of individuals diagnosed worldwide and rather than developing new treatments there is a need to explore how existing treatment modalities can be improved and implemented in a simpler and more cost-effective way To address this need Metacognitive Training for Depression DMCT was developed as a low-cost easy-to-implement cognitive behavioral therapy-based group intervention The aim of Metacognitive Training is to reduce depressive symptoms by working with the patients cognitive biases from a metacognitive perspective The effectiveness of this method which has been proven effective by studies in the literature is presented with a pilot study on older adults in 2018 Since the studies evaluating the effectiveness of the Metacognitive Training-Silver program are limited and it has not yet been adapted to Turkish culture this study aims to evaluate the effectiveness of the Metacognitive Training-Silver program in older adults diagnosed with depression
Detailed Description:
According to the Global Burden of Disease GBD-2019 report mental disorders have been at the top of the global burden of disease list between 1990 and 2019 Depression ranks first among mental disorders with disability and psychosocial dependence The worldwide prevalence rate of depression is 38 and it is a common disorder The prevalence rate in adults is 5 and the prevalence rate in adults aged 60 and over is 57 According to the 2021 data from the US Centers for Disease Control and Prevention compared to the general population the rate of depression is 135 higher in older adults who need home healthcare services and 115 higher in hospitalized older adults A recent systematic review and meta-analysis 2022 found that the global prevalence rate of depression in older adults was 284 and that the prevalence of depression in older adults is high although there are variations by geographical location diagnosticscreening tools sample size representativeness and study quality The isolation measures taken to prevent the spread of the COVID-19 pandemic have negative psychological effects on the protection of vulnerable groups including older adults Therefore the pandemic is reported to have led to a significant increase in major depression cases globally with an estimated 281 increase With the COVID-19 pandemic there is an increase in the demand for mental health services due to the increase in the incidence of depression and anxiety Depression is more than a short-term emotional response to mood swings and psychological difficulties experienced in daily life Especially recurrent and moderate or severe depression is an important health problem The individuals daily life is negatively affected functionality decreases andor suicide may occur
Depression is a serious mental disorder characterized by symptoms such as depressed mood or loss of interestdesire In addition to these important symptoms DSM-5 Diagnostic and Statistical Manual of Mental Disorders criteria include sleep problems changes in appetiteweight psychomotor restlessnessagitation loss of energy concentration problems feelings of worthlessness or guilt and recurrent suicidal thoughts Over time this illness leads to cognitive and social dysfunction
In the treatment of depression multimodal treatment options need to be carried out simultaneously Although there are known effective treatments for mental disorders more than 75 of people in low- and middle-income countries do not receive treatment Barriers to effective care include a lack of financial resources lack of legal regulations lack of trained health professionals and stigma Therefore psychotherapeutic interventions in inpatientoutpatient mental health facilities for psychosocial rehabilitation are insufficient and effective care management is needed to address this problem
In the treatment of depression only medication can be used due to various factors such as patient preference and economic reasons However despite medication the disability and decreased functionality seen in patients are not sufficient for the rehabilitation of the patient Insight into the disease and low compliance with treatment emphasizes the need for psychotherapies and psychosocial interventions In this sense cognitive-behavioral therapy approaches and family interventions are an essential complement to psychopharmacology
Metacognitive Training MCT was created by Steffen Moritz 2007 focusing on psychosis Studies conducted using MCT show that MCT is beneficial in patients with schizophrenia and psychosis reduces the severity of delusions and shows a positive effect even after 6 months of follow-up Following these results Metacognitive Training for Depression D-MCT which focuses on cognitive biases specific to depression was developed based on the Metacognitive Training for Psychosis program Metacognitive Training for Depression is a new treatment option for depression and is a variant of cognitive behavioral therapy that adopts a metacognitive perspective by focusing on changing cognitive biases and dysfunctional attitudes In the first pilot study conducted by Jelinek et al 2013 it was proven that there was a significant decrease in depressive symptoms cognitive distortions and rumination and an increase in self-esteem In other randomized controlled studies conducted by Jelinek and colleagues at the end of Metacognitive Training for Depression and at 6-month follow-up it was determined that there was more improvement in depressive symptoms and a decrease in dysfunctional metacognitive beliefs In secondary analyses conducted 35 years later it was found that positive effects were still seen in the groups where Metacognitive Training for Depression was applied The adaptation study of the Metacognitive Training for Depression program to Turkish culture was conducted by Okyay and Taş 2017 and the results of the study show that there is a significant difference in the data of Rumi Positive Negative Scales Ruminative Reactions Scale and Self-Efficacy Scale in depression patients who were administered this program In another study 2022 after Metacognitive Training for Depression there was a decrease in the Beck Depression Scale and Cognitive Distortions Scale scores depression and cognitive distortion levels of patients
The presentation of the positive effects of Metacognitive Training for Depression with high level of evidence has contributed to the development of the Metacognitive Training for Older Adults MCT-Silver program for depression in older adults Metacognitive Training-Silver focuses on helping individuals move away from thought patterns that feedsupport depression and focuses on physical changes that occur during the aging process coping with loss and adapting to new social roles Metacognitive Training-Silver addresses how to identify and reinterpret values in life for individuals aged 60 and over and how to move towards accepting situations that cannot be preventedchanged In the first pilot study 2018 of the Metacognitive Training-Silver program a significant reduction in depressive symptoms and dysfunctional attitudes was found Therefore more studies are needed to prove the effectiveness of the Metacognitive Training-Silver program
The Metacognitive Training-Silver program has not yet been adapted to Turkish culture and studies are needed to prove its effectiveness in Turkey In this direction a randomized controlled trial is planned to evaluate the effectiveness of the Metacognitive Training-Silver program in older adults diagnosed with depression
Depression is a serious mental disorder characterized by symptoms such as depressed mood or loss of interestdesire In addition to these important symptoms DSM-5 Diagnostic and Statistical Manual of Mental Disorders criteria include sleep problems changes in appetiteweight psychomotor restlessnessagitation loss of energy concentration problems feelings of worthlessness or guilt and recurrent suicidal thoughts Over time this illness leads to cognitive and social dysfunction
In the treatment of depression multimodal treatment options need to be carried out simultaneously Although there are known effective treatments for mental disorders more than 75 of people in low- and middle-income countries do not receive treatment Barriers to effective care include a lack of financial resources lack of legal regulations lack of trained health professionals and stigma Therefore psychotherapeutic interventions in inpatientoutpatient mental health facilities for psychosocial rehabilitation are insufficient and effective care management is needed to address this problem
In the treatment of depression only medication can be used due to various factors such as patient preference and economic reasons However despite medication the disability and decreased functionality seen in patients are not sufficient for the rehabilitation of the patient Insight into the disease and low compliance with treatment emphasizes the need for psychotherapies and psychosocial interventions In this sense cognitive-behavioral therapy approaches and family interventions are an essential complement to psychopharmacology
Metacognitive Training MCT was created by Steffen Moritz 2007 focusing on psychosis Studies conducted using MCT show that MCT is beneficial in patients with schizophrenia and psychosis reduces the severity of delusions and shows a positive effect even after 6 months of follow-up Following these results Metacognitive Training for Depression D-MCT which focuses on cognitive biases specific to depression was developed based on the Metacognitive Training for Psychosis program Metacognitive Training for Depression is a new treatment option for depression and is a variant of cognitive behavioral therapy that adopts a metacognitive perspective by focusing on changing cognitive biases and dysfunctional attitudes In the first pilot study conducted by Jelinek et al 2013 it was proven that there was a significant decrease in depressive symptoms cognitive distortions and rumination and an increase in self-esteem In other randomized controlled studies conducted by Jelinek and colleagues at the end of Metacognitive Training for Depression and at 6-month follow-up it was determined that there was more improvement in depressive symptoms and a decrease in dysfunctional metacognitive beliefs In secondary analyses conducted 35 years later it was found that positive effects were still seen in the groups where Metacognitive Training for Depression was applied The adaptation study of the Metacognitive Training for Depression program to Turkish culture was conducted by Okyay and Taş 2017 and the results of the study show that there is a significant difference in the data of Rumi Positive Negative Scales Ruminative Reactions Scale and Self-Efficacy Scale in depression patients who were administered this program In another study 2022 after Metacognitive Training for Depression there was a decrease in the Beck Depression Scale and Cognitive Distortions Scale scores depression and cognitive distortion levels of patients
The presentation of the positive effects of Metacognitive Training for Depression with high level of evidence has contributed to the development of the Metacognitive Training for Older Adults MCT-Silver program for depression in older adults Metacognitive Training-Silver focuses on helping individuals move away from thought patterns that feedsupport depression and focuses on physical changes that occur during the aging process coping with loss and adapting to new social roles Metacognitive Training-Silver addresses how to identify and reinterpret values in life for individuals aged 60 and over and how to move towards accepting situations that cannot be preventedchanged In the first pilot study 2018 of the Metacognitive Training-Silver program a significant reduction in depressive symptoms and dysfunctional attitudes was found Therefore more studies are needed to prove the effectiveness of the Metacognitive Training-Silver program
The Metacognitive Training-Silver program has not yet been adapted to Turkish culture and studies are needed to prove its effectiveness in Turkey In this direction a randomized controlled trial is planned to evaluate the effectiveness of the Metacognitive Training-Silver program in older adults diagnosed with depression
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None