REVIEW ARTICLE

Psychological Treatments For

Depression and Anxiety in
Dementia and Mild Cognitive
Impairment
:
Systematic
review and Meta Analysis

2nd GROUP

Fathin Nabila Kistie

1313010001
Arkina Putri Dewanti
1313010005
Edy Sudarmono
1313010008
Andika Fajar Nugroho
1313010017
Rifki Ghifari Akbar
1313010021
Mukhammad Arifin
1313010025
Nur Azizah Hafaz
1313010038
Rosella Alfi Sahara
1313010040
Agnes Triana Dewi
1313010042
Amelia Maris
1313010049

BACKGROUND

BACKGROUND
Anxiety

and Depression have substantial

impact on outcomes as they decrease the
ability to live independently and result in higher
caregiver burden
In people with MCI (Major Cognitives
Impairment), early symptomps of depression
can often be resistant to antidepressant
Therefore, psychological treatments adapted
for use with people with cognitives impairment

AIMS OF THE ARTICLE

Dementia
and
Anxiety

Pharmacot
herapy ?
THERAPY
Psychother
apy ?

Both of
them ?

Is to evaluate the evidence of effectiveness of

psychological treatments in treating depression
and anxiety in people with dementia and MCI
( Major Cognitives Impairment )

METHODS

SUBJECTS

Identified of 349 references through database

searching.
The methods use Randomised Control Trial ( RCTs )
that included control group and comparisan group
receiving no spesific psychological intervention
Inclusion criteria for participants :
Older adults with dementia (+)
Alzheimer disease
Organic brain Syndromes
Major cognitives impairment
*criteria based ICD 10, DSM IV or comparable

DATA ANALYSIS

DATA COLLECTION
Searched the Cochrane Dementia and
Cognitive Improvement
Groups Specialized Register and major
healthcare databases
1. MEDLINE
2. Embase
3. CINHAL
4. PsycINFO
5. ALIOS (www.medicine.ox.ac.uk/alois/).
6. LILACS;

DATA COLLECTION
Any

psychological therapy designed to reduce

depressive and anxiety symptoms in people
with dementia, which was defined as any
intervention that:
Was
designed to reduce anxiety and
depression or improve adaptive functioning
Was based on a psychological theory
Involved a structured interaction between a
facilitator and a participant, incorporating
psychological methods.

DATA COLLECTION
The point of therapies search for :
Primary objectives :
Determine whether psychological interventions reduce
depression and anxiety in people with dementia and
MCI
Secondary objectives :
Quality of life enchancement
Activites of daily living
Neuropsychiatric symptoms
Cognition
Caregiver depression

INSTRUMENT OF PSYCOTHERAPY
INCLUDES

EXCLUDES

CBT ( Cognitives
Behavior Therapy )
Relaxation training
therapies
Psychodinamic therapies
Interpersonal therapies
Supportives therapies

Medication
Exercise
Reminiscence
therapy
Music therapy
Art and drama
therapy
Befriending or
bibliotherapy

DISCUSSION RESULTS

RESULTS
Primary outcomes :
Depression
The effect of psychological treatment was
significantly in reducing depressive symptoms
for people with dementia.
Anxiety
Psychological treatment reduced clinicianrated anxiety measured with the rating Anxiety in
Dementia scale.

RESULTS
Secondary outcomes:
Psychological treatment had no effect on

Quality of life
Activities of daily living
Neuropsychiatric symptoms
Cognition
Caregiver depression

DISCUSSIONS
The

results of six RCTs with a total of

439 participants (216 receiving
psychological treatment, 223 in control
groups) showed that psychological
treatments reduce depressive and
anxiety symptoms in people with
dementia measured with a clinicianrated tool.

DISCUSSIONS
Moreover,

all of these studies targeted

symptoms of anxiety and depression through a
structured psychological approach(therapist
and patient communication)
Although there was no effect of psychological
treatment on secondary outcomes, such as
ADL, quality of life, neuropsychiatric symptoms
and cognition, or on caregiver depression.

DISCUSSIONS

A limitation of this review, therefore, is the substantial

variation between studies in terms of the nature,
duration and intensity of the psychological therapy
evaluated, which may contribute to difficulties when
interpreting the data.
Also the psychosocial nature including cognitive
stimulation, cognitive rehabilitation, reminiscence and
activity-based interventions are not aimed specifically
at anxiety or depression
However, in some studies the control condition was
enriched beyond usual care, as opposed to standard
care, indicating that the efficacy of psychological
therapies may be potentially underestimated.

COMPARISON OF PREVIOUS
DATA
This

study was similar to previous research,

which showed that psychotherapy is more
effective therapy. But in previous studies are
still very limited and only in mild dementia.
While in this study used a comprehensive and
sensitive strategy to identify studies; the first
(V.O.) and second author (A.Q.) independently
conducted the selection of studies, data
extraction and assessments of risk of bias.

CONCLUSIONS
The

evidence from six RCTs suggests

that psychological treatments are
effective in reducing symptoms of
depression and anxiety for people with
dementia

LACK AND SUGGESTION

This

article have a lack is not mentioned

name of the drug effect as well as a
pharmacology.
Suggestions: name of the drug need to
be mentioned even though only a few,
and combination therapy should clear
between pharmacotherapy and
psycotherapy