BACKGROUND. Late life depression has been called the common cold of
geriatric psychiatry, but usually it is treated in primary care settings using
medication, however because of fears about side effects and poor
compliance rates with medication, psychological treatments approaches
may be a valuable treatment alternative. This study provides an empirical
evaluation of Cognitive Behaviour Therapy (CBT) alone versus Treatment
as usual (TAU) alone (generally pharmacotherapy) for late life depression
in a UK primary care setting.
METHOD. General Practitioners in Fife and Glasgow referred 114
Participants to the study with 44 meeting inclusion criteria and 40
participants providing data that permitted analysis. All participants had a
diagnosis of Major Depressive Episode. Participants were randomly
allocated to receive either TAU alone or CBT alone.
RESULTS. Participants in both treatment conditions benefited from treatment
with reduced scores on primary measures of mood at end of treatment.
However, one-Way ANOVAs and repeated measures ANOVAs performed
between the two treatment conditions showed no differences between each
treatment at the end of treatment and at 3 and 6 months follow-up on any of
the primary outcome measures. When taking account of differences in
living arrangements, CBT may be beneficial in reducing depression scores
and hopelessness at the end of treatment and at 6 months follow-up. When
evaluating outcome in terms of numbers of participants meeting Research
Diagnostic Criteria for depression, there were significant differences
favouring the CBT condition at the end of treatment and at 3 months
follow-up after treatment.
CONCLUSIONS. Both the CBT alone and the TAU
alone treatment conditions produced significant reductions in depressive
symptoms at the end of treatment and at 6 months follow-up. Psychological
therapy (CBT) on its own is shown to be an effective treatment procedure
for mild to moderate late life depression and has utility as a treatment
alternative for older people who cannot or will not tolerate physical
treatment approaches for depression.