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Review: pharmacotherapy and psychotherapy similarly effective for depression in older adults

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Q Is pharmacotherapy more effective than psychotherapy for depressed older adults?

METHODS

Embedded ImageDesign:

Systematic review with meta analysis.

Embedded ImageData sources:

MEDLINE, Cochrane Database, PsycINFO, and PSYNDEX (search date not stated).

Embedded ImageStudy 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.

Embedded ImageOutcomes:

Clinician-rated or self-rated symptom severity, response, remission.

MAIN RESULTS

Eighty nine controlled studies, including 70 randomised controlled trials …

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