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Q Is pharmacotherapy more effective than psychotherapy for depressed older adults?
Systematic review with meta analysis.
MEDLINE, Cochrane Database, PsycINFO, and PSYNDEX (search date not stated).
Study selection and analysis:
Included studies compared pharmacotherapeutic or psychotherapeutic interventions versus control (eg, placebo or waiting list) in older adults (mean or median age ⩾60 years) with major or minor depressive or dysthymic disorder (ICD-10, DSM-III, DSM-IIIR or DSM-IV). Exclusions: combined, maintenance or collaborative treatments; studies recording insufficient data for analysis. Continuous measures were meta-analysed with Cohen’s d using a random-effects model. Odds ratios and Mantel–Haenszel effect estimates were calculated for dichotomous outcomes.
Clinician-rated or self-rated symptom severity, response, remission.
Eighty nine controlled studies, including 70 randomised controlled trials (RCTs) met inclusion criteria. Pharmacotherapy was assessed in 62 studies and psychotherapy in 32 (5 studies tested both) over an …
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