[Cognitive behavioral therapy for depressed older outpatients--a controlled, randomized trial].
OBJECTIVE
There is a lack of scientific evidence of psychotherapy with depressed elderly. In a controlled randomized trial we compare a cognitive behavioral group intervention with a waiting list control condition. It is expected that cognitive behavior therapy is more efficient in reducing depressive symptoms than the control group at post-treatment as well as at follow-up.


METHODS
A total of 100 older adults presently fulfilling the diagnosis of a depressive disorder but not showing any signs of cognitive impairment were randomly assigned (ratio 2 : 1) to either cognitive behavior therapy (N=65) or to waiting list condition (N=35). Assessment took place at pre-treatment, after 3 months of treatment or waiting, and after 6 months follow-up.


RESULTS
As expected, cognitive behavior group therapy was superior to waiting list control in all measures at post-treatment as well as at follow-up (intent-to-treat analysis). These effects are statistically and clinically relevant and not influenced by parallel treatment with antidepressant medication. After cognitive behavior therapy 36 patients were in complete remission but only 4 after three months of waiting. Six patients in the control group became even worse during the 3 months waiting while only 1 patient under cognitive behavior therapy has to be considered as treatment failure.


CONCLUSIONS
Cognitive behavioral group treatment is a well accepted, successful intervention for older adults. Waiting for treatment is problematic. It does not only produce no changes in symptomatology but even leads to worsening of depression in a large number of subjects.
Hautzinger
M
M
Eberhard-Karls-Univesität, Psychologisches Institut, Abteilung Klinische und Entwicklungspsychologie, Christophstrasse 2, 72072 Tübingen, Germany. hautzinger@uni-tuebingen.de
Welz
S
S
D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008609:Mental Status Schedule; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D011615:Psychotherapy, Group; D015203:Reproducibility of Results