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Cognitive-behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer’s disease


Aboulafia-Brakha, T., Suchecki, D., Gouveia-Paulino, F., Nitrini, R., Ptak, R.


Aging & Mental Health, Volume: 18, No.: 6, Pages.: 801-808

Year of Publication



Background: Family caregivers of patients with dementia frequently experience psychological stress, depression and disturbed psychophysiological activity, with increased levels of diurnal cortisol secretion.; Objectives: To compare the effects of a cognitive-behavioural group therapy (CBT) to a psychoeducation group programme (EDUC) on cortisol secretion in caregivers of patients with moderate Alzheimer’s disease (AD).; Method: Caregivers of AD outpatients were semi-randomly allocated to one of two intervention programmes (CBT or EDUC) consisting of eight weekly sessions. Twenty-six participants completed the study. Before and after intervention, salivary cortisol was collected at four different times of the day. Effects of the interventions were evaluated with self-report psychological scales and questionnaires related to functional abilities and neuropsychiatric symptoms of the AD relative.; Results: Only in the CBT group did salivary cortisol levels significantly decrease after intervention, with a large effect size and high achieved power. Both groups reported a reduction of neuropsychiatric symptoms of their AD relative after intervention.; Conclusion: Psychoeducation for caregivers may contribute to a reduction of neuropsychiatric symptoms of AD patients while CBT additionally attenuates psychophysiological responses to stressful situations in caregivers, by reducing diurnal cortisol levels. This may lead to a positive impact in the general health of the caregiver, eventually resulting in better care of the AD patient.;

Bibtex Citation

@article{Aboulafia_Brakha_2014, doi = {10.1080/13607863.2014.880406}, url = {}, year = 2014, month = {feb}, publisher = {Informa {UK} Limited}, volume = {18}, number = {6}, pages = {801--808}, author = {T. Aboulafia-Brakha and D. Suchecki and F. Gouveia-Paulino and R. Nitrini and R. Ptak}, title = {Cognitive{textendash}behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer{textquotesingle}s disease}, journal = {Aging {&} Mental Health} }


aged, alzheimer, alzheimer disease, biological markers, brazil, burden, caregiver, caregivers, cognitive behavioural therapy, cognitive therapy, cortisol, cost of illness, dementia, education, female, humans, hydrocortisone, isolation purification, male, metabolism, middle aged, neuropsychiatric symptoms, physiopathology, psychoeducation, psychology, psychotherapy group, questionnaires, saliva, secretion, stress, stress, psychological

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Randomised Controlled Trial

Type of Outcomes

Behaviour, Carers’ Mental Health

Type of Interventions

Intervention for Carers

Carer Focussed Interventions

Training programmes / workshops including behavioural training