Effectiveness of treatments for depression in older people.
OBJECTIVE
To conduct a systematic review of the evidence for the effectiveness of a range of possible treatments for depression in older people.


METHODS
Literature search using the PubMed, PsycInfo and Cochrane Library databases.


RESULTS
Treatments that have been suggested to be effective for depression were grouped under three categories: medical treatments, psychological treatments, and lifestyle changes/alternative treatments. We describe each treatment, review the studies of its effectiveness in people aged > or = 60 years, and give a rating of the level of evidence.


CONCLUSIONS
The treatments with the best evidence of effectiveness are antidepressants, electroconvulsive therapy, cognitive behaviour therapy, psychodynamic psychotherapy, reminiscence therapy, problem-solving therapy, bibliotherapy (for mild to moderate depression) and exercise. There is limited evidence to support the effectiveness of transcranial magnetic stimulation, dialectical behaviour therapy, interpersonal therapy, light therapy (for people in nursing homes or hospitals), St John's wort and folate in reducing depressive symptoms.
Frazer
Cathy J
CJ
Centre for Mental Health Research, Australian National University, Canberra, ACT 0200, Australia. cathy.frazer@anu.edu.au
Christensen
Helen
H
Griffiths
Kathleen M
KM
D000368:Aged; D000728:Androgens / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D000529:Complementary Therapies; D003863:Depression / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods; D004565:Electroconvulsive Therapy; D006801:Humans; D008019:Life Style; D008280:Magnetics / Q000627:therapeutic use; D011613:Psychotherapy / Q000379:methods; D013739:Testosterone / Q000627:therapeutic use
D000728:Androgens; D000928:Antidepressive Agents; D013739:Testosterone