Comparative effectiveness of psychotherapies for depressed elders.

Abstract

Ninety-one eldeis with a major depressive disorder (MOD) were treated for 16 to 20 sessions of behavioral, cognitive, or brief psychodynamic psychotherapy. Prior to treatment 20 of these subjects were assigned to a 6-week delayed treatment control condition. By the end of 6 weeks patients in the treatment conditions showed improvement, whereas controls did not. Overall, 52% of the treatment sample attained remission by termination; another 18% showed significant improvement. The remainder still met criteria for MDD at the conclusion of therapy. A number of outcome measures indicated no significant main effects for group and no significant Group X Time interactions, suggesting that all three modalities were equally effective in obtaining positive results. The number of elders responding to these treatments compares favorably with younger samples in other studies, indicating the efficacy of psychotherapy for the treatment of depression in the elderly.

A meta-analysis of randomized trials of behavioural treatment of depression

“…Behavioural therapy ( Behavioural (8) Cognitive ( [11] Thompson (1987) Older adults community 67.07 (5.8) 67…”

Behavioral activation for depression in older adults: Theoretical and practical considerations

“…This study also collected data from a pedometer as an objective measure of the client's physical activity. Several studies assessed self-rated engagement in terms of frequency and pleasantness of activities (Meeks et al, 2006(Meeks et al, , 2008Rokke et al, 1999;Thompson et al, 1987;Yon & Scogin, 2009) and frequency and duration of social and physical activity (Quijano et al, 2007). Only two studies included staff-reported activity participation and direct observation of activity participation and affective responses (Meeks et al, 2006(Meeks et al, , 2008.…”

“…They presented with major or minor depression, and comorbid anxiety was assessed in five studies (Acierno et al, 2012;Dozeman et al, 2011;Meeks et al, 2006;Thompson et al, 1987;Turner & Leach, 2009). Few studies included older adults with cognitive impairment (Snarski et al, 2011;Teri et al, 1997), chronic medical illness (Dozeman et al, 2011;Meeks et al, 2008;Quijano et al, 2007), chronic pain Meeks et al, 2006;Quijano et al, 2007), or diagnoses of psychiatric disorders such as schizophrenia (Snarski et al, 2011); thus, there is limited evidence for the effectiveness of behavioral activation with such individuals.…”

“…Studies in the community included outpatient clinics (Acierno et al, 2012;Bottonari, Roberts, Thomas, & Read, 2008;Gallagher & Thompson, 1982;Lazzari, Egan, & Rees, 2011;Rokke, Tomhave, & Jocic, 1999;Thompson, Gallagher, & Breckenridge, 1987;Turner & Leach, 2009) and the client's home (Quijano et al, 2007;Teri, Logsdon, Uomoto, & McCurry, 1997;Yon & Scogin, 2009). Studies in residential care settings included assisted living (Cernin & Lichtenberg, 2009;Dozeman et al, 2011), nursing homes (Meeks, Looney, Van Haitsma, & Teri, 2008;Meeks, Teri, Van Haitsma, & Looney, 2006), a shortterm rehabilitation unit (Sood, Cisek, Zimmerman, Zaleski, & Fillmore, 2003), and inpatient psychiatric care facilities (Clignet, Van Meijel, Van Straten, Lampe, & Cuijpers, 2012;Snarski et al, 2011).…”

Implications of therapist effects for the design and analysis of comparative studies of psychotherapies.

“…The Beck, Hollon, Young, Bedrosian, and Budenz (1985) and Rush, Beck, Kovacs, and Hollon (1977) studies (data from these two studies were combined), the Luborsky andCrits-Christoph (1988) and the Thompson, Gallagher, and Breckenridge (1987) studies all yielded estimates of therapist effects equal to zero. Most of the other studies had modest therapist main effects (in the 5-10% of variance range).…”