Psychological treatment of late‐life depression: a meta‐analysis of randomized controlled trials

Abstract

SUMMARYBackground Older meta-analyses of the effects of psychological treatments for depression in older adults have found that these treatments have large effects. However, these earlier meta-analyses also included non-randomized studies, and did not include newer high-quality randomized controlled trials. Methods We conducted a meta-analysis of randomized studies on psychological treatments for depression in older adults. Results Twenty-five studies were included, of which 17 compared a psychological intervention to a control condition (mainly waiting list and care-as-usual control groups). The quality of the included studies varied. Psychological treatments have moderate to large effects on depression in older adults (standardized mean effect size d ¼ 0.72). Heterogeneity was very low. No differences were found between individual, group or bibliotherapy format, or between cognitive behavioral therapy and other types of psychological treatment. The effects were comparable in studies where depression was defined according to diagnostic criteria, and those in which depression was measured with self-rating questionnaires.Conclusion Although the quality of many studies was not optimal, the results of this meta-analysis support the results of earlier meta-analyses, which also included non-randomized studies. Psychological treatments are effective in the treatment of depression in older adults.

Reliability and validity of the Norwegian version of the Severe Impairment Battery (SIB)

“…While the evidence for psychosocial treatment for depression in elderly patients without dementia is strong (Cuijpers et al, 2006), the evidence for psychosocial treatment for depression in dementia is weak (Verkaik R et al, 2005). However, one review has suggested that psychosocial treatment for depression is effective even in patients with dementia (Wilkins et al, 2009).…”

Characteristics of effective psychological treatments of depression: a metaregression analysis

“…These studies have shown that psychological treatments are effective not only in adults with depression but also in older adults (Cuijpers, van Straten, & Smit, 2006), women with postpartum depression (Lumley, Austin, & Mitchell, 2004), and patients with both depression and general medical disorders, including multiple sclerosis (Mohr & Goodkin, 1999), stroke (Hackett, Anderson, & House, 2004), and cancer (Sheard & McGuire, 1999) patients. A large number of studies have also shown that psychological treatments of depression in children and adolescents are effective but with smaller effect sizes than in adults (Weisz, McCarty, & Valeri, 2006).…”

A self-help behavioral activation treatment for geriatric depressive symptoms

“…A more recent meta-analysis of 18 studies was conducted examining the results from only randomized controlled trials in the treatment of late-life depression (Cuijpers, van Straten, & Smit, 2006). Investigators found an overall mean effect size of .72 (95% CI: .57 -.87) for treatment versus mainly waitlist or usual care control conditions.…”

“…In studies investigating the treatment of late-life depression, the results of bibliotherapy versus psychotherapy have been relatively comparable (e.g., Cuijpers et al, 2006;Floyd, Scogin, McKendree-Smith, Floyd, & Rokke, 2004;Floyd et al, 2006). den Boer and colleagues (2004) argue, based on the results of their meta-analysis focusing on selfdirected treatments of emotional disorders, that bibliotherapy exhibits robust effects and more research attention should be directed toward integrating it into medical practice.…”