Metacognitive Training (MCT-Silver) for Older Adults with Depressive Symptoms in Portugal: A Pilot Study

Abstract Purpose Depressive symptoms in older adults represent a significant concern with major life impact. This uncontrolled pilot study evaluated the safety, feasibility and acceptance of metacognitive training for depression in later life (MCT-Silver) among Portuguese older adults. MCT-Silver is an 8-week psychological group intervention targeting (meta)cognitive beliefs to reduce depressive symptoms. The study also assessed changes in depressive symptoms, metacognitive beliefs, quality of life, ruminative responses, self-esteem, and dysfunctional attitudes. Methods A pilot, uncontrolled, single-group study with twenty-nine participants aged ≥ 60 years without cognitive impairment and beck depression inventory-II (BDI-II) scores ≥ 14 were included. Blinded assessments occurred at baseline and post-intervention using patient health questionnaire-9 (PHQ-9) (depression), metacognitions questionnaire-30 (MCQ-30) (metacognitive beliefs), world health organization quality of life instruments-Bref, item 1 (WHOQOL-Bref) (quality of life), ruminative responses scale (RRS-10) (ruminative responses), Rosenberg self-esteem scale (RSE) (self-esteem), and dysfunctional attitudes scale-18B (DAS-18B) (dysfunctional attitudes). Acceptance was assessed with a 21-item questionnaire. Results Participants attended an average of 6 sessions (75%) and evaluated the intervention very positively, indicating they found it to be useful in daily life and fun. We did not receive any negative responses. Pre-post comparisons showed statistically significant changes in depressive symptoms, metacognitive beliefs, quality of life, rumination, self-esteem and dysfunctional attitudes; however, given the uncontrolled design, these findings should be interpreted as preliminary and exploratory rather than as evidence of efficacy. Conclusions Results of this uncontrolled single-group pilot study are encouraging, indicating safety, and feasibility of administration as well as high adherence and acceptance among Portuguese older adults. Given the uncontrolled single-group design, the observed pre-post improvements in clinical outcomes should not be interpreted as evidence of efficacy. Controlled studies are needed to confirm the efficacy of MCT-Silver in this population.