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Depression In The Elderly: The Value Of Cognitive Behavioral Therapy

December 18, 2009
Despite a wide range of effective therapies, seniors may not be getting the treatment they should be for depression, in particular cognitive behavioral therapy, a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. "In older people, depressive symptoms are common, psychological adjustment to aging is complex and associated chronic physical illness limits the use of antidepressants," write Dr. Marc Antony Serfaty of Priory Hospital North London in London, England and colleagues. "Despite this, older people are rarely offered psychological interventions, and only 3 randomized controlled trials of CBT in a primary care setting have been published." To show that CBT is an effective treatment in older people with depressive disorder, the researchers conducted a single-blind, randomized controlled trial, the results of which were published in the December issue of Archives of General Psychiatry. Participants consisted of 204 people age 65 or older with a Geriatric Mental State diagnosis of depression who were recruited from primary care and randomly assigned to receive treatment as usual, treatment as usual plus a talking control or treatment as usual plus CBT. Talking control and CBT were offered for 4 months, and follow-up visits were conducted at 4 and 10 months. "Cognitive behavioral therapy is an effective treatment for older people with depressive disorder and appears to be associated with its specific effects," the study authors write, although they point out that CBT appeared to have little effect on anxiety symptoms or social functioning. "Older people with depression in the primary care setting engage well with talking treatments and benefit from individual CBT. A specific treatment such as CBT is better than simply talking with a warm and empathic therapist. The optimum frequency and timing of CBT sessions in older people needs to be further investigated."