Psychological treatment of late-life depression: a meta-analysis of randomized controlled trials.

BACKGROUND Older meta-analyses of the effects of psychological treatments for depression in older adults have found that these treatments have large effects. However, these earlier meta-analyses also included non-randomized studies, and did not include newer high-quality randomized controlled trials. METHODS We conducted a meta-analysis of randomized studies on psychological treatments for depression in older adults. RESULTS Twenty-five studies were included, of which 17 compared a psychological intervention to a control condition (mainly waiting list and care-as-usual control groups). The quality of the included studies varied. Psychological treatments have moderate to large effects on depression in older adults (standardized mean effect size d = 0.72). Heterogeneity was very low. No differences were found between individual, group or bibliotherapy format, or between cognitive behavioral therapy and other types of psychological treatment. The effects were comparable in studies where depression was defined according to diagnostic criteria, and those in which depression was measured with self-rating questionnaires. CONCLUSION Although the quality of many studies was not optimal, the results of this meta-analysis support the results of earlier meta-analyses, which also included non-randomized studies. Psychological treatments are effective in the treatment of depression in older adults.