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Is psychotherapy for depression equally effective in younger and older adults? A meta-regression analysis

Published online by Cambridge University Press:  01 December 2008

Pim Cuijpers ,
Annemieke van Straten ,
Filip Smit  and
Gerhard Andersson
Pim Cuijpers*
Affiliation:
Department of Clinical Psychology and EMGO Institute, VU University Amsterdam, The Netherlands
Annemieke van Straten
Affiliation:
Department of Clinical Psychology and EMGO Institute, VU University Amsterdam, The Netherlands
Filip Smit
Affiliation:
Department of Clinical Psychology and EMGO Institute, VU University Amsterdam, The Netherlands Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
Gerhard Andersson
Affiliation:
Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Sweden Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
*
Correspondence should be addressed to: Professor Pim Cuijpers, Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. Phone: +31 20 5988757; Fax: +31 20 5988758. Email: [email protected].
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Abstract

Background: It is well established that psychotherapy is effective in the treatment of depression in younger as well as in older adults. Whether these psychotherapies are equally effective in younger and older age groups has not been examined in meta-analytic research.

Methods: We conducted a systematic literature search and included 112 studies with 170 comparisons between a psychotherapy and a control group (with a total of 7,845 participants). Twenty studies with 26 comparisons were aimed at older adults.

Results: We found no indication that psychotherapies were more or less effective for older adults compared to younger adults. The effect sizes of both groups of comparisons did not differ significantly from each other (older adults: d = 0.74; 95% CI: 0.49~0.99; younger adults: d = 0.67; 95% CI: 0.58~0.76). In a multivariate meta-regression analysis, in which we controlled for major characteristics of the participants, the interventions and the study designs, no indication of a difference between psychotherapy in younger and older adults was found.

Conclusions: There appears to be no significant difference between psychotherapy in younger and older adults, although it is not clear whether this is also true for clinical samples, patients with more severe depression, and the older old.

Keywords

meta-analysisdepressionmajor depressive disorderpsychological treatmentpsychotherapyolder adults
Type
Review Article
Information
International Psychogeriatrics , Volume 21 , Issue 1 , February 2009 , pp. 16 - 24
Copyright
Copyright © International Psychogeriatric Association 2008

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References

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. and Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Beck, A. T., Steer, R. A. and Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.CrossRefGoogle Scholar
Churchill, R. et al. (2001). A systematic review of controlled trials of the effectiveness and cost-effectiveness of brief psychological treatments for depression. Health Technology Assessment, 5, 35.Google ScholarPubMed
Cohen, J. (1977). Statistical Power Analysis for the Behavioral Sciences. Orlando, FL: Academic Press.Google Scholar
Cuijpers, P. (1998). Psychological outreach programs for depressed elderly: a meta-analysis of effects and drop-out. International Journal of Geriatric Psychiatry, 13, 41–48.3.0.CO;2-B>CrossRefGoogle Scholar
Cuijpers, P. and Dekker, J. (2005). Psychologische behandeling van depressie: een systematisch overzicht van meta-analyses. Nederlands Tijdschrift voor Geneeskunde, 149, 1892–1897.Google ScholarPubMed
Cuijpers, P., van Straten, A. and Smit, F. (2006). Psychological treatment of late-life depression: a meta-analysis of randomized controlled trials. International Journal of Geriatric Psychiatry, 21, 1139–1149.CrossRefGoogle ScholarPubMed
Cuijpers, P., van Straten, A. and Warmerdam, L. (2007a). Behavioral treatment of depression: a meta-analysis of activity scheduling. Clinical Psychology Review, 27, 318–326.CrossRefGoogle Scholar
Cuijpers, P., van Straten, A. and Warmerdam, L. (2007b). Problem solving therapies for depression: a meta-analysis. European Psychiatry, 22, 9–15.CrossRefGoogle ScholarPubMed
Cuijpers, P., van Straten, A. and Smit, F. (2007c). Psychological treatments of subthreshold depression: a meta-analytic review. Acta Psychiatrica Scandinavica, 115, 434–441.CrossRefGoogle ScholarPubMed
Cuijpers, P., Brännmark, J. G. and van Straten, A. (2008a). Psychological treatment of postpartum depression: a meta-analysis. Journal of Clinical Psychology, 64, 103–118.CrossRefGoogle ScholarPubMed
Cuijpers, P., van Straten, A., van Oppen, P. and Andersson, G. (2008b). Are psychological and pharmacological interventions equally effective in the treatment of adult depressive disorders? A meta-analysis of comparative studies. Journal of Clinical Psychiatry.CrossRefGoogle Scholar
Engels, G. I. and Verney, M. (1997). Efficacy of nonmedical treatments of depression in elders: a quantitative analysis. Journal of Clinical Geropsychology, 3, 17–35.Google Scholar
Gallagher, D. (1981). Behavioral group therapy with elderly depressives: an experimental study. In Upper, D. and Ross, S. (eds), Behavioral Group Therapy (pp. 187–224). Champaign: Research Press.Google Scholar
Gallagher, D. E. and Thompson, L. W. (1982). Treatment of major depressive disorder in older adult outpatients with brief psychotherapies. Psychotherapy, 19, 482–490.CrossRefGoogle Scholar
Gerson, S., Belin, T. R., Kaufman, A., Mintz, J. and Jarvik, L. (1999). Pharmacological and psychological treatments for depressed older patients: a meta-analysis and overview of recent findings. Harvard Review of Psychiatry, 7, 1–28.CrossRefGoogle ScholarPubMed
Gloaguen, V., Cottrauxa, J., Cucherata, M. and Blackburn, I. M. (1998). A meta-analysis of the effects of cognitive therapy in depressed patients. Journal of Affective Disorders, 49, 59–72.CrossRefGoogle ScholarPubMed
Hackett, M. L., Anderson, C. S. and House, A. O. (2004). Interventions for treating depression after stroke. Cochrane Database of Systematic Reviews, Issue 2 Art No: CD003437pub2, doi: 101002/14651858CD003437pub2.Google Scholar
Higgins, J. P. T. and Green, S. (2006). Cochrane Handbook for Systematic Reviews of Interventions 4.2.6. The Cochrane Library, Issue 4. Chichester: John Wiley & Sons.Google Scholar
Higgins, J. P., Thompson, S. G., Deeks, J. J. and Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327, 557–560.CrossRefGoogle ScholarPubMed
Koder, D. A., Brodaty, H. and Anstey, K. J. (1996). Cognitive therapy for depression in the elderly. International Journal of Geriatric Psychiatry, 11, 97–107.3.0.CO;2-W>CrossRefGoogle Scholar
La Rue, A. and McCreary, C. (1991). Emerging issues in the care of the elderly. In Sweet, J. J., Rozensky, R. H. and Tovian, S. M. (eds.), Handbook of Clinical Psychology in Medical Settings (pp. 223–248). New York: Plenum Press.CrossRefGoogle Scholar
Leichsenring, F. (2001). Comparative effects of short-term psychodynamic psychotherapy and cognitive behavioral therapy in depression: a meta-analytic approach. Clinical Psychology Review, 21, 401–419.CrossRefGoogle ScholarPubMed
Lumley, J., Austin, M. P. and Mitchell, C. (2004). Intervening to reduce depression after birth: a systematic review of the randomized trials. International Journal of Technology and Assessment in Health Care, 20, 128–144.CrossRefGoogle ScholarPubMed
McCusker, J., Cole, M., Keller, E., Bellavance, F. and Berard, A. (1998). Effectiveness of treatments of depression in older ambulatory patients. Archives of Internal Medicine, 158, 705–712.CrossRefGoogle ScholarPubMed
Miranda, J., Chung, J. Y., Green, B. L., Krupnick, J., Siddique, J. and Revicki, D. A. (2003). Treating depression in predominantly low-income young minority women: a randomized controlled trial. JAMA 290, 57–65.CrossRefGoogle ScholarPubMed
Mohr, D. C. and Goodkin, D. E. (1999). Treatment of depression in multiple sclerosis: review and meta-analysis. Clinical Psychology: Science and Practice, 6, 1–9.Google Scholar
Pinquart, M., Duberstein, P. R. and Lyness, J. M. (2006). Treatments for later-life depressive conditions: a meta-analytic comparison of pharmacotherapy and psychotherapy. American Journal of Psychiatry, 163, 1493–1501.CrossRefGoogle ScholarPubMed
Scogin, F. and McElreath, L. (1994). Efficacy of psychosocial treatments for geriatric depression: a quantitative review. Journal of Consulting and Clinical Psychology, 62, 69–74.CrossRefGoogle ScholarPubMed
Sheard, T. and McGuire, P. (1999). The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses. British Journal of Cancer, 80, 1770–1780.CrossRefGoogle ScholarPubMed
Weisz, J. R., McCarty, C. A. and Valeri, S. M. (2006). Effects of psychotherapy for depression in children and adolescents: a meta-analysis. Psychological Bulletin, 132, 132–149.CrossRefGoogle ScholarPubMed