Schema therapy day treatment for older adults with personality and comorbid mood disorders: an observational study

Older adults with personality disorders often present in mental health care with chronic and/or treatment resistant affective disorders. This study investigated symptom reduction and improvement of functioning by following an intensive, short-term, day treatment, schema therapy program for this patient group.

A pre-post treatment study evaluating a schema therapy day-treatment (20 wk, 12 hrs) for 30 older (≥60 years) adults with a personality disorder and a comorbid affective disorder. Outcomes measures are the Manchester Short Assessment of Quality of Life, the Young Schema Questionnaire-L2, the Inventory of Depressive Symptomatology-Self Report version, and the Geriatric Anxiety Inventory. Change in outcome measures were expressed as pre-post Cohen's d effect sizes as well as the proportion of patients that improved (reliable change according to Jacobson-Truax) or recovered (clinical significant change according to norm scores).

Cohen's d effect sizes ranged between 1.15 and 1.63. The proportion of patients who recovered ranged from 23% (depression), 40% (schema severity), 43% (Quality of Life) to 57% (anxiety).

Pre-post effect sizes were comparable to younger age groups and larger compared to our previous study evaluating day-treatment based on cognitive-behavioral therapy. Considering these promising results and chronicity of late-life affective disorders, a well-designed randomized controlled trial is warranted.