Social Connections and Late Life Suicide

University of Rochester

Status: Completed

Conditions: Suicidal Ideation; Depression

Treatments: Behavioral: ENGAGE

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02188485

K23MH096936 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

With the long-term goal of improving interventions for late-life suicide, the purpose of this study is to examine whether a mechanism by which behavioral interventions reduce risk for late-life suicide is by increasing social connectedness. The investigators propose to examine whether a manualized intervention that targets connectedness--ENGAGE--increases connectedness in older adults who report clinically significant depression and disconnectedness-operationalized as feeling lonely and/or like a burden on others. The investigators propose a randomized controlled trial comparing the ENGAGE intervention with care-as-usual (CAU), using n=100 primary care patients aged ≥ 60 years who report social disconnectedness (i.e., loneliness or burdensomeness) and either Minor or Major Depression. At baseline, 3-week, 6-week and 10-week assessments, subjects will report on social connectedness, depression, and suicide risk. The investigators hypothesize that those subjects assigned to ENGAGE will report greater increases in connectedness-measured as greater belongingness and lower burdensomeness-compared to CAU; that ENGAGE will produce greater reductions in depression and suicide ideation than CAU; and that changes in depression will be accounted for changes in social connectedness.

Enrollment: 62 patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 60 yrs;
• English speaking;
• Reside in the community;
• Endorse social disconnectedness, as measured by feeling lonely and/or like a burden on others;
• Meet criteria for Minor or Major Depression.

Exclusion criteria

• Imminent risk for suicide;
• Active psychosis;
• Significantly impaired cognitive functioning (i.e., MOCA <23);
• Active substance abuse in the last year (AUDIT score of 5 or more);
• Hearing loss that precludes comfortable communication;
• Residence in a long-term care facility.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

62 participants in 2 patient groups

ENGAGE: a social engagement intervention

Experimental group

Description:

ENGAGE is a brief psychotherapy that specifically targets increased social engagement and activity. The study will use the ENGAGE manual developed by Drs. Alexopoulos, Arean and their colleagues, focusing on increased engagement in activities that allow subjects to be social (targeting thwarted belongingness) or contribute to the well-being of others (targeting perceived burdensomeness).

Treatment:

Behavioral: ENGAGE

Care-as-Usual

No Intervention group

Description:

Care as usual in primary care with study assessments.