Cuijpers Pim, van Straten Annemieke, Smit Filip
Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands.
Int J Geriatr Psychiatry. 2006 Dec;21(12):1139-49. doi: 10.1002/gps.1620.
Older meta-analyses of the effects of psychological treatments for depression in older adults have found that these treatments have large effects. However, these earlier meta-analyses also included non-randomized studies, and did not include newer high-quality randomized controlled trials.
We conducted a meta-analysis of randomized studies on psychological treatments for depression in older adults.
Twenty-five studies were included, of which 17 compared a psychological intervention to a control condition (mainly waiting list and care-as-usual control groups). The quality of the included studies varied. Psychological treatments have moderate to large effects on depression in older adults (standardized mean effect size d = 0.72). Heterogeneity was very low. No differences were found between individual, group or bibliotherapy format, or between cognitive behavioral therapy and other types of psychological treatment. The effects were comparable in studies where depression was defined according to diagnostic criteria, and those in which depression was measured with self-rating questionnaires.
Although the quality of many studies was not optimal, the results of this meta-analysis support the results of earlier meta-analyses, which also included non-randomized studies. Psychological treatments are effective in the treatment of depression in older adults.
早期关于老年人抑郁症心理治疗效果的荟萃分析发现，这些治疗有显著效果。然而，这些早期的荟萃分析也纳入了非随机研究，且未纳入更新的高质量随机对照试验。
我们对老年人抑郁症心理治疗的随机研究进行了荟萃分析。
纳入了25项研究，其中17项将心理干预与对照条件（主要是等待列表和常规护理对照组）进行了比较。纳入研究的质量各不相同。心理治疗对老年人抑郁症有中度至显著效果（标准化平均效应量d = 0.72）。异质性非常低。在个体治疗、团体治疗或图书治疗形式之间，以及认知行为疗法与其他类型心理治疗之间未发现差异。根据诊断标准定义抑郁症的研究与使用自评问卷测量抑郁症的研究结果相当。
尽管许多研究的质量并非最佳，但该荟萃分析的结果支持了早期荟萃分析的结果，早期分析也纳入了非随机研究。心理治疗对老年人抑郁症有效。
