01/12/2011 Medicine Psychology
DOI: 10.1002/gps.2680 SemanticScholar ID: 34262495 MAG: 1999857385

The effectiveness of behavioural therapy for the treatment of depression in older adults: a meta‐analysis

Publication Summary

Objective To systematically review the effectiveness of behavioural therapy in depressed older adults. Methods Electronic databases were searched to July 2009. Reference lists of systematic reviews and identified studies from the search strategy were also screened. Randomised controlled trials (RCTs) of behavioural therapy compared with waiting list controls or other psychotherapies in older adults (aged ≥55 years) with clinical depression were included. One author independently identified studies for inclusion. Two authors extracted data and assessed the included studies for risk of bias. Estimates of depression were combined using a random effects model and the I2 statistic to examine heterogeneity. Results Four RCTs were included in the meta-analysis. For post-treatment self-rated depression symptoms, behavioural therapy was not significantly more effective than a waiting list control [standardised mean difference (SMD) of −0.52, 95% confidence interval (CI) −1.35 to 0.30, p = 0.21, n = 117], cognitive therapy (SMD of 0.23, 95% CI −0.24 to 0.70, p = 0.33, n = 134) or brief psychodynamic therapy (SMD of −0.37, 95% CI −0.84 to 0.11, p = 0.13, n = 69). For post-treatment clinician-rated depression, behavioural therapy was not significantly more effective than cognitive therapy or brief psychodynamic therapy but was significantly more effective than a waiting list control (weighted mean difference (WMD) of −5.68, 95% CI −7.71 to −3.66, p < 0.001, n = 117). Conclusions Behavioural therapy in depressed older adults appears to have comparable effectiveness with alternative psychotherapies. Further research is recommended with the need for larger sample sizes, more clarity on trial design and the intervention, longer term follow-up and concomitant economic evaluations. Copyright © 2011 John Wiley & Sons, Ltd.

CAER Authors

Avatar Image for Simon Gilbody

Prof. Simon Gilbody

University of York - Director of the Mental Health and Addictions Research Group

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