title: Non-pharmacological prevention of major depression among community-dwelling older adults: a systematic review of the efficacy of psychotherapy interventions.
abstract: Depression is a major public health burden among the aging population. While older adults prefer non-pharmacological treatment, few options for psychotherapy are available in primary care settings, which is where older adults tend to receive mental health services. Indicated prevention is a cost-effective, public health approach to prevent major depressive disorder among people with depressive symptoms who do not yet meet standard criteria for major depression. We critically reviewed randomized controlled trials (RCTs) that assessed the efficacy of psychotherapy among community-dwelling older adults with subthreshold depression (depressive symptoms that do not meet standard criteria for major depression). We examined the intervention types, results, internal validity, and external validity of five studies. We used the United States Preventive Services Task Force (USPSTF) guidelines to rate the quality of the studies and to provide recommendations. Results suggest that psychotherapy is a safe and cost-effective method to reduce the public health burden of depression among older adults with subthreshold depression.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. sulee@jhsph.edu
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Lee
authors.forename: Mary Kathryn
authors.initials: MK
authors.lastname: Franchetti
authors.forename: Anuar
authors.initials: A
authors.lastname: Imanbayev
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
authors.forename: Adam P
authors.initials: AP
authors.lastname: Spira
authors.forename: Hochang B
authors.initials: HB
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000191:economics / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000191:economics / Q000379:methods; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000191:economics / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome