title: The effectiveness of behavioural therapy for the treatment of depression in older adults: a meta-analysis.
abstract: OBJECTIVE
  To systematically review the effectiveness of behavioural therapy in depressed older adults.
  
  
  METHODS
  Electronic databases were searched to July 2009. Reference lists of systematic reviews and identified studies from the search strategy were also screened. Randomised controlled trials (RCTs) of behavioural therapy compared with waiting list controls or other psychotherapies in older adults (aged ≥55 years) with clinical depression were included. One author independently identified studies for inclusion. Two authors extracted data and assessed the included studies for risk of bias. Estimates of depression were combined using a random effects model and the I(2) statistic to examine heterogeneity.
  
  
  RESULTS
  Four RCTs were included in the meta-analysis. For post-treatment self-rated depression symptoms, behavioural therapy was not significantly more effective than a waiting list control [standardised mean difference (SMD) of -0.52, 95% confidence interval (CI) -1.35 to 0.30, p = 0.21, n = 117], cognitive therapy (SMD of 0.23, 95% CI -0.24 to 0.70, p = 0.33, n = 134) or brief psychodynamic therapy (SMD of -0.37, 95% CI -0.84 to 0.11, p = 0.13, n = 69). For post-treatment clinician-rated depression, behavioural therapy was not significantly more effective than cognitive therapy or brief psychodynamic therapy but was significantly more effective than a waiting list control (weighted mean difference (WMD) of -5.68, 95% CI -7.71 to -3.66, p < 0.001, n = 117).
  
  
  CONCLUSIONS
  Behavioural therapy in depressed older adults appears to have comparable effectiveness with alternative psychotherapies. Further research is recommended with the need for larger sample sizes, more clarity on trial design and the intervention, longer term follow-up and concomitant economic evaluations.
authors.affiliation: Humber Mental Health Trust, Trust Headquarters, Willerby Hill, Willerby, East Yorkshire, UK.
authors.forename: Zara
authors.initials: Z
authors.lastname: Samad
authors.forename: Stephen
authors.initials: S
authors.lastname: Brealey
authors.forename: Simon
authors.initials: S
authors.lastname: Gilbody
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D006113:United Kingdom; D014850:Waiting Lists