The effectiveness of behavioural therapy for the treatment of depression in older adults: a meta-analysis
Article first published online: 9 FEB 2011
Copyright © 2011 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 26, Issue 12, pages 1211–1220, December 2011
How to Cite
Samad, Z., Brealey, S. and Gilbody, S. (2011), The effectiveness of behavioural therapy for the treatment of depression in older adults: a meta-analysis. Int. J. Geriat. Psychiatry, 26: 1211–1220. doi: 10.1002/gps.2680
- Issue published online: 8 NOV 2011
- Article first published online: 9 FEB 2011
- Manuscript Accepted: 29 NOV 2010
- Manuscript Received: 13 JUL 2010
- behavioural therapy;
- cognitive therapy;
To systematically review the effectiveness of behavioural therapy in depressed older adults.
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.
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).
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.