Review2001

Treatments for late life depression in primary care--a systematic review

Ulrich Freudenstein · Carol Jagger · Antony J Arthur · Norbert Donner‐Banzhoff

45 citations0/0 files storedFamily Practice

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Mental Health Treatment and Access Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Treatment of Major Depression

Abstract

BACKGROUND: Depression is common among older people. It is associated with increased mortality and use of health services. We could identify no prior systematic review of treatment for depression in either primary care attenders or population samples of older people. OBJECTIVES: The aim of this study was to carry out a systematic review of trials of treatments for depression of patients over 60 years of age in primary care or population samples. METHODS: We searched Medline, Embase, Cinahl, the Cochrane Library, Psyclit, BIDS--Social Science and BIDS--Science Citation Indices for trials of drug treatment, interpersonal psychotherapy, cognitive behavioural psychotherapy, counselling and social interventions for late life depression in English, French or German published between 1980 and June 1999. RESULTS: Of the studies identified, only two were of patients over 60 years of age and met all inclusion criteria for content and quality. Three further studies that were not restricted to but included patients over the age of 60 years also fulfilled our criteria. We found no studies of psychological therapies for depression in older people. With few exceptions, studies were limited to older people who reached a diagnostic threshold and excluded those with 'subcase level depression'. CONCLUSION: There is little evidence of effectiveness for a variety of treatment approaches for depression in older people in primary care, particularly in those with less severe depression. As older people take more medication, making contra-indications to the use of antidepressant drugs more likely, there is a pressing need for studies of the efficacy of non-pharmacological interventions in primary care settings.

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References

1997Case-finding instruments for depression 1999Review of community prevalence of depression in later life 1998Changes in public attitudes to depression during the Defeat Depression Campaign 1999Prognosis of Depression in Elderly Community and Primary Care Populations: A Systematic Review and Meta-Analysis 1994Efficacy of psychosocial treatments for geriatric depression: A quantitative review.1989Psychiatric disorders and 15-month mortality in a community sample of older adults.2008Cerebrospinal Fluid Levels of Acetylcholinesterase, Monoamines and Oxytocin during Labour, Parturition, Vaginocervical Stimulation, Lamb Separation and Suckling in Sheep 1994Lifetime Risk of Depression

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