Meditation for Dementia Caregivers Major Depressive Disorder in Family Dementia Caregivers
| Status: | Completed |
|---|---|
| Conditions: | Depression, Depression, Major Depression Disorder (MDD), Neurology |
| Therapuetic Areas: | Neurology, Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 45 - Any |
| Updated: | 11/18/2018 |
| Start Date: | April 2014 |
| End Date: | September 2015 |
Central Meditation and Imagery Therapy for Major Depressive Disorder in Family Dementia Caregivers
Family dementia caregivers provide a needed service to relatives with dementia and to
society, but are often at risk for consequences to their own health such as depression,
reduced immune system function, and burnout. Central Meditation and Imagery Therapy (CMIT) is
a novel group mindfulness and guided imagery intervention designed to help caregivers reduce
depressive symptoms and cope with the stress of caregiving. A small study suggested that CMIT
techniques are feasible for dementia caregivers, and resulted in a reduction of depressive
and anxiety symptoms. The largest benefits were shown to occur within the first 4 weeks, and
were maintained at 3 months post treatment. The early benefits of CMIT were further described
in a recent trial of CMIT for patients with recurrent depression, which demonstrated
promising improvement in depressive symptoms, with the largest benefits occurring within the
first 4 weeks. We have therefore shortened CMIT for caregivers from 8 weeks to 4 weeks, and
aim to study the effects of the four-week version (Central Meditation and Imagery Therapy,
Short Term, CMIT-ST) on dementia caregivers with elevated depressive symptoms. We will
conduct a pilot feasibility of CMIT-ST versus home relaxation practice with 24 dementia
caregivers. Half of the caregivers will be randomly assigned to receive a relaxation
recording, while the other half will receive CMIT-ST. After 4 weeks, the group assigned to
the relaxation recording will then have the opportunity to participate in CMIT-ST.
To measure the effects of CMIT-ST, we will obtain depression symptom ratings and
questionnaires about psychological symptoms before and after CMIT-ST. We will also study the
biological effects of CMIT-ST. We will do so by measuring brain activity, recording the pulse
in order to determine variation in beat to beat intervals of the heart, and studying patterns
of gene expression.
society, but are often at risk for consequences to their own health such as depression,
reduced immune system function, and burnout. Central Meditation and Imagery Therapy (CMIT) is
a novel group mindfulness and guided imagery intervention designed to help caregivers reduce
depressive symptoms and cope with the stress of caregiving. A small study suggested that CMIT
techniques are feasible for dementia caregivers, and resulted in a reduction of depressive
and anxiety symptoms. The largest benefits were shown to occur within the first 4 weeks, and
were maintained at 3 months post treatment. The early benefits of CMIT were further described
in a recent trial of CMIT for patients with recurrent depression, which demonstrated
promising improvement in depressive symptoms, with the largest benefits occurring within the
first 4 weeks. We have therefore shortened CMIT for caregivers from 8 weeks to 4 weeks, and
aim to study the effects of the four-week version (Central Meditation and Imagery Therapy,
Short Term, CMIT-ST) on dementia caregivers with elevated depressive symptoms. We will
conduct a pilot feasibility of CMIT-ST versus home relaxation practice with 24 dementia
caregivers. Half of the caregivers will be randomly assigned to receive a relaxation
recording, while the other half will receive CMIT-ST. After 4 weeks, the group assigned to
the relaxation recording will then have the opportunity to participate in CMIT-ST.
To measure the effects of CMIT-ST, we will obtain depression symptom ratings and
questionnaires about psychological symptoms before and after CMIT-ST. We will also study the
biological effects of CMIT-ST. We will do so by measuring brain activity, recording the pulse
in order to determine variation in beat to beat intervals of the heart, and studying patterns
of gene expression.
Inclusion Criteria:
1. Caregivers of relatives with dementia who present to the UCLA Alzheimer and Dementia
Care Program, or other UCLA geriatric or memory clinics for evaluation of dementia,
cognitive impairment and/or co-existing behavioral disturbances.
2. Caregivers will be identified by the family member with dementia or the physician as
the primary source of assistance and/or support
3. 45 years of age or older
4. Patient Health Questionnaire Score > 9
5. In contact with the individual with dementia at least three times/week for no less
than one year, and a relative of the care-recipient (i.e., spouse or adult child).
6. Adequate written and oral fluency in English to understand and complete study forms
and converse with study personnel.
Exclusion Criteria:
- Current diagnosis of schizophrenia or any psychotic disorder including psychotic
depression, mania, alcohol or drug dependence, mental retardation, any pervasive
developmental disorder or cognitive disorder (according to DSM-IV) criteria.
2. Medically unstable, delirious, or terminally ill (e.g. medical illness requiring
hospitalization or intense outpatient management, such as heart disease; heart attack
in the past 6 months; congestive heart failure; severe heart arrythmias; unstable
hypertension; poorly controlled diabetes; or pending surgery).
3. Past history of skull fracture; cranial surgery entering the calvarium; space
occupying intracranial lesion; stroke/ aneurysm; Parkinson's or Huntington's disease;
or Multiple Sclerosis.
4. Participants regularly practicing (≥ 2 times per week) any of the techniques
utilized in the study to reduce stress: meditation, guided imagery, yoga.
5. Active suicidal plan, or suicide attempt within the past month. 6. Excessive use of
alcohol, i.e., men whose alcohol consumption exceeds 14 standard drinks per week or 4
drinks per day, and women whose alcohol consumption exceeds 7 standard drinks per week
or 3 drinks per day.
7. Needing to adjust or change anti-depressant treatment, including medications,
psychotherapy, repetitive Transcranial Magnetic Stimulation (rTMS), Electroconvulsive
Therapy (ECT), or Vagus Nerve Stimulation (VNS).
8. Ideas of harm toward the care recipient, current violence, or an APS report on
file.
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