Dialectical Behavior Therapy for Depressed Older Adults: A Randomized Pilot Study

Lynch, Thomas R.; Morse, Jennifer Q.; Mendelson, Tamar; Robins, Clive J.

doi:10.1097/00019442-200301000-00006

Cited by 384Personality Disorders and PsychopathologyPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Dialectical Behavior Therapy for Depressed Older Adults: A Randomized Pilot Study

Lynch, Thomas R., Morse, Jennifer Q., Mendelson, Tamar, Robins, Clive J.·2003·The American Journal of Geriatric Psychiatry

DOI 10.1097/00019442-200301000-00006

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Abstract

Objective Although there is evidence for the efficacy of antidepressants and for some individual and group psychotherapy interventions for depressed older adults, a significant number of these do not respond to treatment. Authors assessed the benefits of augmenting medication with group psychotherapy.Methods They randomly assigned 34 (largely chronically) depressed individuals age 60 and older to receive 28 weeks of antidepressant medication plus clinical management, either alone (MED) or with the addition of dialectical behavior therapy skills-training and scheduled telephone coaching sessions (MED+DBT).Results Only MED+DBT showed significant decreases on mean self-rated depression scores, and both treatment groups demonstrated significant and roughly equivalent decreases on interviewer-rated depression scores. However, on interviewer-rated depression, 71% of MED+DBT patients were in remission at post-treatment, in contrast to 47% of MED patients. At a 6-month follow-up, 75% of MED+DBT patients were in remission, compared with only 31% of MED patients, a significant difference. Only patients receiving MED+DBT showed significant improvements from pre- to post-treatment on dependency and adaptive coping that are proposed to create vulnerability to depression.Conclusion Results from this pilot study suggest that DBT skills training and telephone coaching may offer promise to effectively augment the effects of antidepressant medication in depressed older adults.

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Modifications of DBT are effective in chronic depression in the elderly.
“and chronic depression in the elderly (Lynch, Morse, Mendelson & Robins, 2003)”
From Effects of mindfulness on psychological health: A review of empirical studies (2011) · cites this paper as Lynch, Morse, Mendelson & Robins, 2003
DBT has received empirical support for its efficacy in treating patients with BPD and other conditions, such as binge eating disorder and treatment-resistant depression.
“Among several evidence-based approaches, DBT has received empirical support in its efficacy in treating patients with BPD and other conditions, such as binge eating disorder and treatment-resistant depression [6, 12, 13].”
From Implementation of brief dialectical behavior therapy skills training among borderline personality disorder patients in Malaysia: feasibility, acceptability, and preliminary outcomes (2021) · cites this paper as [12]
DBT has been found to be effective in several psychiatric disorders characterized by ED, e.g., complex post-traumatic stress disorder (c-PTSD), depression, anxiety and eating disorders.
“In addition to BPD, DBT has been found to be effective in several psychiatric disorders characterized by ED, e.g., complex post-traumatic stress disorder (c-PTSD), depression, anxiety and eating disorders (Safer et al., 2001; Lynch et al., 2003; Chen et al., 2008; Harley et al., 2008; Bohus et al., 2013; Neacsiu et al., 2014).”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Lynch et al., 2003
Other studies have found that changes in depression, hopelessness and quality of life measures were sustained at follow-up.
“Other studies have found that changes in depression (e.g. Lynch et al., 2003; Neacsiu et al., 2014; Mehlum et al., 2019), hopelessness (e.g. Mehlum et al., 2019) and quality of life (Carter et al., 2010) measures were sustained at follow-up.”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Lynch et al., 2003

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Authors: Lynch, T. R., Morse, J. Q., Mendelson, T., & Robins, C. J.
Affiliations: Duke University (US)
Corresponding author: Lynch, Thomas R.
ORCID: Lynch, Thomas R.
Morse, Jennifer Q.
Mendelson, Tamar
Venue: The American Journal of Geriatric Psychiatry
Publisher: Elsevier BV
Published: 2003-01
Volume: 11
Issue: 1
Pages: 33-45
ISSN: 1064-7481 (ISSN-L)
DOI: 10.1097/00019442-200301000-00006
OpenAlex: W2032583580
Cited by: 384
References: 72
Citations by year: 2026: 2 · 2025: 8 · 2024: 9 · 2023: 9 · 2022: 17 · 2021: 45 · 2020: 15 · 2019: 6 · 2018: 15 · 2017: 25 · 2016: 12 · 2015: 30 · 2014: 24 · 2013: 24 · 2012: 17
FWCI: 14.25
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: American Journal of Geriatric Psychiatry (publishedVersion)
PubMed (publishedVersion)
ePrints Soton (University of Southampton) (submittedVersion)
Funders: National Institute of Mental Health (R01 MH-54846, P30 MH401159-14, R01MH054846, R03MH057799)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: dialectical behavior therapy, geriatric depression, antidepressant augmentation, group therapy, telephone coaching, DBT skills training, chronic depression, treatment-resistant depression, remission, dependency, adaptive coping
MeSH terms: Adaptation, Psychological, Affect, Aged, Aged, 80 and over, Behavior Therapy, Chronic Disease, Depressive Disorder, Female, Humans, Male, Middle Aged, Pilot Projects, Psychotherapy, Group

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Dialectical Behavior Therapy for Depressed Older Adults: A Randomized Pilot Study

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