Evidence map›Paper›PMID 28288407›Full record

Trial reportJournal of affective disorders2017

Therapeutic relationship in the treatment of geriatric depression with executive dysfunction.

Ryan A Mace, David A Gansler, Michael K Suvak, Carla M Gabris, Patricia A Areán, Patrick J Raue, George S Alexopoulos

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of affective disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Ryan A MaceDepartment of Psychology, Suffolk University, 73 Tremont Street, Boston, MA 02114, USA. Electronic address: rmace@suffolk.edu.
David A GanslerDepartment of Psychology, Suffolk University, 73 Tremont Street, Boston, MA 02114, USA. Electronic address: dgansler@suffolk.edu.
Michael K SuvakDepartment of Psychology, Suffolk University, 73 Tremont Street, Boston, MA 02114, USA. Electronic address: msuvak@suffolk.edu.
Carla M GabrisDepartment of Psychology, Suffolk University, 73 Tremont Street, Boston, MA 02114, USA; Northwell Health Solutions, Great Neck, NY, USA. Electronic address: carla2939@gmail.com.
Patricia A AreánDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. Electronic address: parean@uw.edu.
Patrick J RaueDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. Electronic address: praue@uw.edu.
George S AlexopoulosDepartment of Psychiatry, Weill Cornell Medical College, New York, NY, USA. Electronic address: gsalexop@med.cornell.edu.
Suffolk University · USUniversity of Washington · USCornell University · US

Funding

Target engagement of a reward exposure therapy (Engage) for late life depressionR01MH102252 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI ALEXOPOULOS, GEORGE S · 2014 to 2018
$2.0M
Treating Older Patients with Major Depression and Severe COPDR01MH076829 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI ALEXOPOULOS, GEORGE S · 2008 to 2012
$1.9M
Treating Depression in Low-Income Elderly with CIND/AMCIK24MH074717 · NIMH · UNIVERSITY OF WASHINGTON · PI AREAN, PATRICIA A. · 2005 to 2016
$1.7M
NIMH NIH HHS K24 MH074717NIMH NIH HHS R01 MH076829NIMH NIH HHS R01 MH102252
6 · The paper itself

Abstract

backgroundThe effects of therapeutic relationship (TR) in elder mental health are understudied. A greater understanding of TR in geriatric psychotherapy is particularly needed for treating late-life depression with executive dysfunction, which predicts poor response to antidepressant medication and presents unique clinical challenges.

methodsParticipants were older patients (N = 220) with major depression and executive dysfunction who received 12 weeks of problem-solving therapy or supportive therapy in a randomized control trial. Multilevel growth curve modeling and latent change scores were used to analyze TR dimensions of Understanding and Accepting at the patient level (individual patient ratings, N = 194) and therapist level (ratings of each therapist averaged across participants, N = 10).

resultsTR predicted reduction of depression in both treatment groups, while treatment×TR interactions were not significant. Patients treated by therapists with higher average Understanding (patient and therapist level) and Accepting (therapist level) ratings had greater decreases in depression. The patient level×therapist level interaction for Understanding approached statistical significance (p=.065), suggesting a synergistic effect on treatment outcome. Together, Understanding and Accepting predicted 21% of variance in depression level changes. LIMITATIONS: TR was not assessed throughout the course of treatment (only after the first therapy session and at post-treatment) and did not include ratings from an objective evaluator.

conclusionsAssessment of patient's experience of the TR and of therapist ability to foster Understanding and Accepting can play a significant role in the delivery of geriatric psychosocial interventions.

Indexed as

Executive FunctionProfessional-Patient RelationsAgedAntidepressive AgentsFemaleHumansMajor Depressive DisorderMalePsychotherapyTreatment OutcomeAntidepressive AgentsDepressionGeriatricsGrowth curve modelingTherapeutic relationshipTreatment outcomes

Identifiers

PMID28288407
PMCPMC5390484
OpenAlexW2591628105

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.