Scientific Abstract

Background: Family caregivers of persons living with dementia often experience high rates of depression and suicidal ideation (SI). However, the feasibility and impact of therapies on caregiver SI has been largely unexplored. Mentalizing imagery therapy (MIT) aims to reduce psychological symptoms through mindfulness and guided imagery to facilitate self and other understanding. This pilot study sought to examine the impact of a 4-week MIT program versus a psychosocial support group (SG) on depression and SI.

Methods: A secondary analysis of data from an RCT of MIT or SG for family dementia caregivers (n=46) was performed, identifying participants with (n=23) and without (n=23) SI.  Group attendance and home practice were compared between caregivers with and without SI. For SI participants in both MIT and SG, SI change was evaluated categorically with Fisher’s exact test.  Group*Time effects on depression were assessed with mixed linear models.

Results: Attendance in both groups, and home practice in MIT, were similar among participants with and without SI. Caregivers with SI who received MIT evinced greater reductions in depression (p<.01) and SI (p= 0.02) relative to SG. The majority of caregivers receiving MIT (9/11) demonstrated improvement in SI post-group, while most caregivers receiving SG (9/12) demonstrated persistent or worsening SI post-group.

Conclusions: Participation in this 4-week RCT was feasible for caregivers with SI. Brief MIT resulted in important benefits for SI, while the SG showed no acute SI benefit.  The role of MIT for improving SI in family caregivers should be confirmed with adequately powered trials.