Cognitive behavioural therapy helpful in depressed elderly

Pooled data indicate that cognitive behavioural therapy (CBT) is helpful in the elderly with major or minor depression, dysthymia, or depressive symptoms, but so are other approaches, according to UK researchers.

As Dr Rebecca Gould said, "Older people who received CBT showed a reduction in their symptoms of depression when compared with those offered no CBT or 'usual treatment'. However, CBT was no more effective at doing this than other types of treatment (such as behavioural therapy or brief psychodynamic therapy) or social support (such as a discussion group or education)."

How the research was done

In an online paper the Journal of the American Geriatrics Society, Dr Gould of King's College London and colleagues note that pharmacotherapy and CBT are currently recommended for depressed adults of any age. Most trials have been conducted in younger populations, however.

The pooled data in the new report are from 23 randomised trials in which the average age was 68.4 years.

Patients receiving CBT were compared with active controls who were involved in activities including supportive therapy, psychoeducation and discussion groups. Non-active controls consisted of patients who received treatment as usual or who were put on a waiting list. One study compared pharmacotherapy with CBT and 10 studies permitted concurrent pharmacotherapy.

Lengths of treatment ranged from one to 12 months. The number of participants ranged from as few as 30 to more than 1 100.

CBT is beneficial

Overall, at the end of the intervention, by clinician and self-rated measures, CBT was significantly more effective at reducing depressive symptoms when compared with non-active controls. However, the effect was no greater than in active controls.

There were similar results at six months.

No differences were seen in efficacy between CBT and pharmacotherapy or other psychotherapies.

The investigators observe that "More high-quality randomised controlled trials comparing CBT with active controls need to be conducted before strong conclusions can be drawn about the efficacy of CBT for depression in older people."

Nevertheless, added Dr Gould, the findings suggest that "any form of talking therapy (and not just specifically CBT) or social support may be beneficial to older people with depression."

(Reuters Health, October 2012)

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