A randomized controlled trial to evaluate the efficacy of metacognitive training for older adults with depression (MCT-Silver) in Portugal: study protocol

Lara Guedes de Pinho; Celso Silva; César Fonseca; Bruno Morgado; Manuel Lopes; Steffen Moritz; Lena Jelinek; Brooke C Schneider

doi:10.3389/fpsyg.2023.1167860

A randomized controlled trial to evaluate the efficacy of metacognitive training for older adults with depression (MCT-Silver) in Portugal: study protocol

Front Psychol. 2023 Oct 31:14:1167860. doi: 10.3389/fpsyg.2023.1167860. eCollection 2023.

Authors

Lara Guedes de Pinho^#^{1

2}, Celso Silva^#^{2

3}, César Fonseca^{1

2}, Bruno Morgado^{4

5}, Manuel Lopes^{1

2}, Steffen Moritz⁶, Lena Jelinek⁶, Brooke C Schneider⁶

Affiliations

¹ Department of Nursing, University of Évora, Évora, Portugal.
² Comprehensive Health Research Centre (CHRC), Évora, Portugal.
³ Higher School of Health, Polytechnic Institute of Beja, Beja, Portugal.
⁴ Universitat Rovira i Virgili, Tarragona, Spain.
⁵ Hospital Garcia de Orta, Almada, Portugal.
⁶ University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

^# Contributed equally.

Abstract

Introduction: Depression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life (MCT-Silver).

Methods: This is a study protocol of an observer-blind, parallel-group, randomized controlled trial to compare the efficacy of MCT-Silver with a treatment as usual (TAU) control group among older adults (age 65 years and older) with depressive symptoms according to the Montgomery-Asberg Depression Scale. Participants will be tested at three assessment time points (baseline, immediately following the intervention [8 weeks], and 3 months after the intervention). The primary outcome is change in self-rated depression symptoms assessed by the Beck Depression Inventory (BDI-II). Secondary outcomes include clinician-rated depression, self-esteem, dysfunctional beliefs, metacognitive beliefs, ruminations, attitudes toward aging and quality of life. A self-designed subjective appraisal rating scale consisting of 21-items will be used to assess participant acceptance of MCT-Silver.

Discussion: MCT-Silver is an innovative intervention, which aims to reduce dysfunctional thoughts as well as depression-related behaviors and coping strategies through the metacognitive perspective. Until now, the training has only been tested in Germany. It is expected that after 8 weeks of treatment and 3 months later, the experimental group will demonstrate significant reductions in depressive symptoms, metacognitive beliefs, dysfunctional attitudes and ruminative responses compared to the TAU group. Moreover, quality of life, self-esteem, and attitudes towards aging will be significantly improved in MCT-Silver compared to the TAU group.

Clinical trial registration: ClinicalTrials.gov, NCT05640492.

Keywords: cognitive behavioral therapy; depression; depressive symptoms; geriatric depression; intervention; metacognitive training; older adults; randomized controlled trial.

Associated data

ClinicalTrials.gov/NCT05640492

Grants and funding

This research was funded by the Federal Ministery of Education and Research (Bundesministerium für Bildung und Forschung; #57610786), Foundation for Science and Technology (FCT: Fundação para a Ciência e Tecnologia). Programme for Cooperation in Science between Portugal and German. This work is funded by national funds through the Foundation for Science and Technology, under the project UIDP/04923/2020.