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Review of the efficacy of psychotherapy vs. pharmacotherapy for depression treatment in old age

Marcia Scazufca Cintia MCB Matsuda About the authors

INTRODUCTION: Depression is one of the most prevalent mental disorders in old age. Although pharmacological treatments have proven efficacy, recurrence of depression is common. This paper reviews the existing clinical trials on the efficacy of psychotherapy versus pharmacological treatments, alone or combined, for depression treatment in elderly people. METHODS: Internet search of two databases (Medline and PsychINFO) were performed to find out randomized-controlled trials, published between 1984 and 2001, examining the efficacy of psychotherapies versus pharmacotherapy for depression in individuals aged 60 or over with diagnosis of dysthymia, minor or major depression. RESULTS: Four studies were included, three of them compared the efficacy of psychotherapy versus pharmacotherapy during the acute and continuation phase for depression treatment, and one assessed the efficacy of these treatments during the maintenance phase. Treatments that comprised psychotherapy (alone or combined with medication) showed to be more efficacious than pharmacotherapy in the three studies of major depression subjects. Psychotherapy was not more efficacious than placebo or antidepressants in the study of dysthymia or minor depression subjects. CONCLUSION: Empirical evidence on the efficacy of psychotherapy versus pharmacotherapy for depression treatment in elderly people is scant and inconclusive, suggesting a great need of further clinical trials investigating the efficacy of psychotherapy for depression treatment in later life.

Aged; Depression; Psychotherapy; Clinical trial [publication type]; Therapeutics

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