Impact of the WHELD/Brief Psychosocial Therapy intervention on psychosis in people with dementia: A Cluster Randomized Trial

Neuropsychiatric Symptoms (NPS), particularly psychosis, are common in dementia and can significantly impact patient outcomes, caregivers and disease trajectory. Psychosis, which includes hallucinations and delusions, occurs in up to 50% of people with dementia and has been linked with lower quality of life and faster cognitive decline. While best practice guidelines have highlighted the importance of non-pharmacological treatments for NPS, evidence-based non-pharmacological approaches are limited. This exploratory analysis of a cluster randomized control trial (RCT) from the WHELD programme compares the WHELD/Brief Psychosocial Therapy intervention with treatment as usual in a 9-month trial across 69 UK nursing homes (N=8477, 553 completed). The current report analyzed outcomes for the participants with dementia-related psychosis (N=163) participating in the trial. Whilst the WHELD/Brief Psychosocial Therapy intervention did not significantly reduce NPI psychosis score, it did significantly improve apathy (p=0.006), agitation (p=0.038) and quality of life (p=0.01) in participants with psychosis. In addition there was a non-significant numerical improvement in caregiver perceived disruptiveness. These findings suggest that whilst the WHELD/ Brief Psychosocial Therapy intervention does not directly alleviate psychosis in people with dementia, it does significantly improve related neuropsychiatric symptoms and quality of life, offering meaningful benefits to people with dementia experiencing distressing psychotic symptoms.