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Brief psychotherapy in Alzheimer's disease

Randomised controlled trial

Department of Psychiatry, Wythenshawe Hospital, Manchester

ELSE GUTHRIE, MD, FRCPsych

Department of Psychiatry, Manchester Royal Infirmary, Manchester

FEDERICA MARINO-FRANCIS and CHARLOTTE BUSBY, MRCPsych

Department of Psychiatry, Wythenshawe Hospital, Manchester

JULIE MORRIS, MSc

Department of Medical Statistics, Wythenshawe Hospital, Manchester

EVE RUSSELL, MD, MRCPsych, FRANK MARGISON, FRCPsych, SEAN LENNON, FRCPsych and JANE BYRNE, FRCPsych

Department of Psychiatry, Wythenshawe Hospital, Manchester, UK

Correspondence: Professor Alistair Burns, Department of Psychiatry, 2nd Floor, Education and Research Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK. Tel: +44 (0)161 291 5887; fax: +44 (0)161 291 5882; e-mail: Alistair.Burns{at}manchester.ac.uk

Declaration of interest None.

Background Although there is good evidence that interventions for carers of people with Alzheimer's disease can reduce stress, no systematic studies have investigated psychotherapeutic intervention for patients themselves. This may be important in the earlier stages of Alzheimer's disease, where insight is often preserved.

Aims The aim was to assess, in a randomised controlled trial, whether psychotherapeutic intervention could benefit cognitive function, affective symptoms and global well-being.

Method Individuals were randomised to receive six sessions of psychodynamic interpersonal therapy or treatment as usual; cognitive function, activities of daily living, a global measure of change, and carer stress and coping were assessed prior to and after the intervention.

Results No improvement was found on the majority of outcome measures. There was a suggestion that therapy had improved the carers' reactions to some of the symptoms.

Conclusions There is no evidence to support the widespread introduction of brief psychotherapeutic approaches for those with Alzheimer's disease. However, the technique was acceptable and helpful individually.

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