Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, New York, NY.
Am J Geriatr Psychiatry. 2023 Jul;31(7):514-524. doi: 10.1016/j.jagp.2023.02.001. Epub 2023 Feb 12.
BACKGROUND/OBJECTIVE: Given the chronicity of depression and anxiety disorders in late life, maintenance treatments may have a role in preserving healthy functioning. This study aims to understand the state of the science on maintenance psychotherapies for Black, Asian, and Latinx older adults.
Scoping review.
A priori protocol was prospectively published. Four databases were searched up to December 1, 2021. Eligible studies were conducted in the United States or Puerto Rico and focused on maintenance psychotherapies treating depression, anxiety, or both in adults 60+. Due to the underrepresentation of Black, Asian, and Latinx participants, studies were included irrespective of the participant's racial or ethnic background.
A total of 3,623 unique studies were retrieved, and eight studies were included. Two studies represented randomized clinical trials, and six were studies of post hoc analyses. All studies were from the same research team, had similar maintenance treatments, and focused on depression. Studies included racially homogenous samples (94-98% White). The primary outcome was the recurrence of a major depressive episode. Across studies, maintenance psychotherapy shows promise in preventing the recurrence of depression in some older adults.
Expanding the scope of knowledge from achieving optimal functioning to sustaining those changes in older adults is a significant public health challenge given symptom recurrence. The small body of knowledge on maintenance psychotherapies shows a promising direction in maintaining healthy functioning following recovery from depression. However, opportunities remain to expand the evidence of maintenance psychotherapies with a more significant commitment to the inclusion of diverse populations.
背景/目的：鉴于抑郁和焦虑障碍在老年人中的慢性特征，维持治疗可能在保持健康功能方面发挥作用。本研究旨在了解针对黑种人、亚裔和拉丁裔老年人的维持心理疗法的科学现状。
范围综述。
预先制定了方案并进行了前瞻性发表。截至 2021 年 12 月 1 日，四个数据库进行了检索。符合条件的研究在美国或波多黎各进行，重点是针对 60 岁及以上成年人的抑郁、焦虑或两者兼具的维持心理疗法。由于黑种人、亚裔和拉丁裔参与者人数不足，因此无论参与者的种族或族裔背景如何，都纳入了研究。
共检索到 3623 项独特的研究，纳入了 8 项研究。两项研究代表随机临床试验，六项研究为事后分析。所有研究均来自同一个研究团队，维持治疗相似，且都集中于抑郁。研究纳入的样本均为同一种族（94-98%为白人）。主要结局是重性抑郁发作的复发。在所有研究中，维持心理疗法在预防某些老年人的抑郁复发方面显示出一定的前景。
鉴于症状复发，将知识扩展到实现最佳功能扩展到维持老年人的这些变化是一个重大的公共卫生挑战。关于维持心理疗法的知识体系虽然很小，但在从抑郁中恢复后维持健康功能方面显示出了有希望的方向。然而，仍然有机会通过更坚定地致力于纳入不同人群来扩大维持心理疗法的证据。
