Comparison of Desipramine and Cognitive/Behavioral Therapy in the Treatment of Elderly Outpatients With Mild-to-Moderate Depression

Identification of Real and Artifactual Moderators of Effect Size in Meta-Analysis

“…(The issue of HRSD versus BDI effects sizes differences will be dealt with subsequently.) Figure 1 displays a wide range of effect sizes-from about 1 for both medication and psychotherapy in Study 26 (Thompson et al, 2001), to effect sizes above 4 for Studies 17 (McKnight et al, 1992), and 6 (Dimidjian et al, 2006). Tight bunching obscures identification of Studies 3 and 9, Studies 2, 19, and 24, and Studies 8, 12, and 13.…”

Psychological Therapy for Depression and Anxiety in Older Adults

“…Since 1982 there have been nine systematic outcome studies looking at CBT as a treatment for late-life depression; four of these studies use individual CBT and are the product of one research group based at Stanford University in California (Gallagher & Thompson, 1983;Gallagher-Thompson, Hanley-Peterson & Thompson, 1990;Thompson et al, 2001;Thompson, Gallagher & Breckenridge, 1987). Five other systematic evaluations have also been carried out into the efficacy of group based CBT for depression (Arean et al, 1993;Beutler et al, 1987;Kemp, Corgiat & Gill, 1991/2;Rokke, Tomhave & Jocic, 2000;Steuer et al, 1984).…”

“…The prognosis at two-year follow-up for those participants who did not respond to treatment was poor. Thompson et al (2001) randomized 100 out-patients diagnosed with major depressive disorder to one of the three treatment conditions: CBT alone, Desipramine (an antidepressant) medication (ADM) alone and combined CBT/ADM. In each case treatment lasted three to four months and in the CBT condition participants received 16 to 20 sessions.…”

“…Cognitive-behaviour therapy alone is a good treatment alternative for those patients who cannot tolerate medication, or for those older adults who do not wish to be prescribed antidepressants. For more severe levels of depression, there is evidence that CBT in combination with adequate dosages of medication constitutes an appropriate treatment regime (Gerson et al, 1999;Thompson et al, 2001). The main criticism is that the evaluations of individual CBT have mainly been carried out on healthy, community-dwelling older adults who are mainly young-old rather than old-old.…”

Current status of psychotherapy for mental disorders in the elderly

“…The majority of studies comparing therapy with medications have involved IPT, and these studies tend to suggest that the combination of the two may be superior to each alone, acutely and to prevent relapse [2••]. The evidence comparing CBT with medications is limited; one study suggested that CBT was better than desipramine, and that the combination did not confer any additional benefit [19]. In their review, Zeiss and Breckenridge [6] concluded that antidepressants may speed recovery, but that psychotherapy may result in longer-term benefits.…”