CNSPulse

PSYCHOSOCIAL INTERVENTIONS FOR OLDER ADULTS WITH DEPRESSION AND VARYING DEGREES OF COGNITIVE FUNCTIONING AFTER A SUICIDE-RELATED HOSPITALIZATION

Dimitris Kiosses — Weill Cornell Medical College

2026 ASCP Annual Meeting

Specific

Purpose

Psychosocial interventions for hospitalized older adults with varying degrees of cognitive deficits who have been recently hospitalized for suicidality are understudied. The aims of this presentation are to compare depression, emotion regulation, and suicide-related outcomes between two psychosocial interventions for older adults after a suicide related hospitalization: Problem Adaptation Therapy for Suicide Prevention (PATH-SP) and Supportive Therapy (ST). Methodology: 46 participants (50-90 years old) were inpatients of Weill Cornell/NY Presbyterian Hospital and were randomized into PATH-SP (N=23) and ST (N=23). PATHSP utilizes emotion regulation strategies to reduce negative emotions associated with suicidal ideation, employs compensatory strategies to bypass cognitive and functional limitations, and incorporates caregiver participation when necessary. ST focuses on nonspecific therapeutic factors (e.g. conveying empathy, highlighting successful experiences). We assessed depression severity, emotion regulation, suicide outcomes, and treatment satisfaction at discharge, and at 4, 8, and 12 weeks post-discharge.

Results

Participants were severely depressed at admission, actively suicidal, and had on average mild to moderate cognitive deficits and functional impairment. At discharge, participants on average were moderately depressed and had mild suicidal ideation. Participants in both PATH-SP and ST had high treatment satisfaction scores. PATH-SP participants had significantly lower depression scores, high emotion regulation scores, and lower suicide-related re-hospitalization rates than ST participants (p < 0.05). Most relapses occurred in the first 5 months post-discharge.

Importance: PATH-SP reduced hospitalization for suicidality rates in older adults with major depression and varying degrees of cognitive functioning, who have been recently discharged after a suicide-related hospitalization. This is clinically significant because psychosocial interventions for this high suicide risk population are underdeveloped.

References

  1. Kiosses DN, Szanto K, Alexopoulos GS. Suicide in older adults: the role of emotions and cognition. Curr Psychiatry Rep. 2014 Nov;16(11):495.
  2. Bress JN, Arslanoglou E, Banerjee S, Alexopoulos GS, Kiosses DN. Positive valence system function and anhedonia in middle-aged and older adults at high suicide risk. Biol Psychol. 2023 Sep;182:108647.