title: Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: systematic review and meta-analysis.
abstract: BACKGROUND
  Anxiety and depression are common in people with dementia and mild cognitive impairment (MCI), but there is uncertainty about the effectiveness of both pharmacological and psychological therapies.
  
  
  OBJECTIVE
  To evaluate the evidence of effectiveness of psychological treatments in treating depression and anxiety in people with dementia and MCI.
  
  
  METHODS
  We carried out a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological treatment versus usual care in people with dementia and MCI. Primary outcomes were symptoms of anxiety and depression. Secondary outcomes were quality of life, ability to perform daily activities, neuropsychiatric symptoms, cognition and caregivers' self-rated depressive symptoms.
  
  
  RESULTS
  We included six RCTs, involving 439 participants with dementia, which used cognitive-behavioural therapy, interpersonal therapy, counselling or multimodal interventions including a specific psychological therapy. We found beneficial effects for both depression and anxiety. Overall, the quality of the evidence was moderate for depression and low for anxiety, due to the methodological limitations of the studies we identified and the limited number of trials.
  
  
  CONCLUSIONS
  The evidence from six RCTs suggests that psychological treatments are effective in reducing symptoms of depression and anxiety for people with dementia. There is a need for high-quality, multicentre trials including standardised, well-defined interventions.
authors.affiliation: Vasiliki Orgeta, PhD, Division of Psychiatry, University College London; Afifa Qazi, MBBS, MRCPsych, Goodmayes Hospital, North East London Foundation Trust; Aimee Spector, PhD, DClinPsych, Research Department of Clinical, Educational and Health Psychology, University College London; Martin Orrell, PhD, Institute of Mental Health, Nottingham, UK v.orgeta@ucl.ac.uk.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Orgeta
authors.affiliation: Vasiliki Orgeta, PhD, Division of Psychiatry, University College London; Afifa Qazi, MBBS, MRCPsych, Goodmayes Hospital, North East London Foundation Trust; Aimee Spector, PhD, DClinPsych, Research Department of Clinical, Educational and Health Psychology, University College London; Martin Orrell, PhD, Institute of Mental Health, Nottingham, UK.
authors.forename: Afifa
authors.initials: A
authors.lastname: Qazi
authors.affiliation: Vasiliki Orgeta, PhD, Division of Psychiatry, University College London; Afifa Qazi, MBBS, MRCPsych, Goodmayes Hospital, North East London Foundation Trust; Aimee Spector, PhD, DClinPsych, Research Department of Clinical, Educational and Health Psychology, University College London; Martin Orrell, PhD, Institute of Mental Health, Nottingham, UK.
authors.forename: Aimee
authors.initials: A
authors.lastname: Spector
authors.affiliation: Vasiliki Orgeta, PhD, Division of Psychiatry, University College London; Afifa Qazi, MBBS, MRCPsych, Goodmayes Hospital, North East London Foundation Trust; Aimee Spector, PhD, DClinPsych, Research Department of Clinical, Educational and Health Psychology, University College London; Martin Orrell, PhD, Institute of Mental Health, Nottingham, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Orrell
mesh_terms: D001007:Anxiety / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D060825:Cognitive Dysfunction / Q000523:psychology*; D003376:Counseling / Q000379:methods; D003704:Dementia / Q000523:psychology*; D003863:Depression / Q000628:therapy*; D006801:Humans; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome