Morgado Bruno, Silva Celso, Agostinho Inês, Brás Filipe, Amaro Pedro, Lusquinhos Leonel, Silva Maria Revés, Fonseca Cesar, Albacar-Riobóo Núria, Guedes de Pinho Lara
Escola de Doctorat, Universitat Rovira y Virgili, 43005 Tarragona, Spain.
Higher School of Health, Polytechnic University of Portalegre, 7300-110 Portalegre, Portugal.
Healthcare (Basel). 2024 Dec 18;12(24):2551. doi: 10.3390/healthcare12242551.
UNLABELLED: The global ageing population faces rising depression rates due to social, economic, and health changes. Depression in older adults, often linked to isolation and health issues, requires comprehensive care. Psychotherapeutic interventions could be effective in reducing symptoms, offering personalized and holistic support. Particularly low-threshold interventions, such as those offered in community-dwelling older adults, which older adults can easily access and which may reduce stigma, promise to close the treatment gap. This review examines community-based psychotherapeutic interventions for older adults with depression. METHODS: This review investigates psychotherapeutic interventions for reducing depressive symptoms in older adults in a community setting. RCTs were assessed using Joanna Briggs Institute tools. The following databases were searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and the Psychology and Behavioral Sciences Collection. RESULTS: A meta-analysis of 13 studies with 1528 participants showed a medium, significant pooled effect size at post-intervention (Hedges' = -0.36, < 0.001) and substantial heterogeneity. Follow-up analysis of studies indicated a small, non-significant effect (Hedges' = -0.17, = 0.27). Group interventions, particularly the "reminiscence protocol", had the largest significant effect. DISCUSSION: This systematic review and meta-analysis found that in community-dwelling older adults' group psychotherapeutic interventions, particularly the "reminiscence protocol" and "modified behavioral activation treatment" are most effective for reducing depressive symptoms. Individual psychotherapeutic interventions like "prevention of suicide in primary care elderly" and "behavioral activation" also show effectiveness, with group psychotherapeutic interventions being generally more effective than when these treatments are offered in individual psychotherapeutic interventions. CONCLUSION: Group and individual psychotherapeutic interventions reduce depressive symptoms in community-dwelling older adults, with group psychotherapeutic interventions being more effective.
未标注：由于社会、经济和健康方面的变化，全球老龄化人口面临着抑郁症发病率上升的问题。老年人的抑郁症通常与孤独和健康问题有关，需要全面护理。心理治疗干预措施可能对减轻症状有效，提供个性化和整体化的支持。特别是低门槛干预措施，例如为居家老年人提供的那些，老年人可以轻松获得，并且可能减少耻辱感，有望缩小治疗差距。本综述研究了针对老年抑郁症患者的社区心理治疗干预措施。 方法：本综述调查了在社区环境中减轻老年人抑郁症状的心理治疗干预措施。使用乔安娜·布里格斯研究所的工具对随机对照试验进行评估。检索了以下数据库：CINAHL Plus全文数据库、MedicLatina、MEDLINE全文数据库以及心理学与行为科学合集。 结果：对13项研究、1528名参与者进行的荟萃分析显示，干预后有中等程度的显著合并效应量（赫奇斯g值 = -0.36，p < 0.001）以及显著的异质性。对研究的随访分析显示效应量较小且不显著（赫奇斯g值 = -0.17，p = 0.27）。团体干预措施，特别是“回忆疗法方案”，具有最大的显著效应。 讨论：本系统综述和荟萃分析发现，在居家老年人中，团体心理治疗干预措施，特别是“回忆疗法方案”和“改良行为激活疗法”对于减轻抑郁症状最为有效。个体心理治疗干预措施，如“初级保健中老年人自杀预防”和“行为激活疗法”也显示出有效性，团体心理治疗干预措施通常比个体心理治疗干预措施更有效。 结论：团体和个体心理治疗干预措施可减轻居家老年人的抑郁症状，团体心理治疗干预措施更有效。
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