Psychological treatment of depression in older adults: A network meta-analysis.

IF 4.3 2区医学 Q1 GERIATRICS & GERONTOLOGY

International psychogeriatrics Pub Date : 2026-04-15 DOI:10.1016/j.inpsyc.2026.100213

Pim Cuijpers, Clara Miguel, Eirini Karyotaki, Mathias Harrer

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引用次数: 0

Abstract

Objectives: Several psychological treatments for depression in older adults have been found to be effective compared to control conditions. It is less clear, however, if these treatments have comparable effects. We aimed to examine the relative effects of these treatments.

Design: Systematic review and network meta-analysis.

Setting: Any outpatient setting.

Participants, interventions, measurements: We included randomized controlled trials examining the effects of psychological treatments in older adults with depression, and comparing a treatment with another treatment or a control condition (care-as-usual and waitlist). Only treatments with at least five trials were included.

Results: We included 86 randomized trials (10,165 participants) examining five types of treatment: cognitive behavior therapy (CBT), behavioral activation therapy (BAT), problem-solving therapy (PST), supportive therapy (SUP) and life review therapy (LRT). The network was relatively well connected. CBT, BAT, PST and LRT were more effective than CAU (SMD range: 0.52-0.99) and WL (SMD range: (0.62-1.10). SUP was not more effective than WL or CAU. All therapies were more effective than SUP (SMD range: 0.43-0.80), except for BAT. LRT was more effective than CBT and BAT. However, we found a significant difference between direct and indirect evidence. After excluding outliers, the general conclusions were similar, except that LRT was no longer superior to other therapies.

Conclusions: CBT, LRT, BAT and PST are effective interventions in the treatment of depression in older adults, and they probably have comparable effects. LRT and CBT have lower drop-out and may be preferrable as first treatment.

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老年人抑郁症的心理治疗：网络荟萃分析。

目的：与对照条件相比，已经发现几种老年抑郁症的心理治疗方法是有效的。然而，目前尚不清楚这些治疗方法是否具有可比较的效果。我们的目的是检查这些治疗的相对效果。设计：系统评价和网络荟萃分析。设置：任何门诊设置。参与者，干预措施，测量：我们纳入了随机对照试验，检查心理治疗对老年抑郁症患者的影响，并将一种治疗方法与另一种治疗方法或对照条件（照旧治疗和等待治疗）进行比较。只纳入了至少5项试验的治疗方法。结果：我们纳入了86项随机试验（10,165名参与者），研究了五种治疗方法：认知行为疗法（CBT）、行为激活疗法（BAT）、问题解决疗法（PST）、支持疗法（SUP）和生活回顾疗法（LRT）。网络连接相对较好。CBT、BAT、PST和LRT均优于CAU （SMD范围：0.52 ~ 0.99）和WL （SMD范围：0.62 ~ 1.10）。SUP并不比WL或CAU更有效。除BAT外，所有治疗均比SUP有效（SMD范围：0.43-0.80）。LRT比CBT和BAT更有效。然而，我们发现直接证据和间接证据之间存在显著差异。排除异常值后，除了LRT不再优于其他治疗外，总体结论相似。结论：CBT、LRT、BAT和PST是治疗老年人抑郁症的有效干预措施，且可能具有可比性。LRT和CBT的辍学率较低，可能是首选的第一种治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International psychogeriatrics 医学-精神病学

CiteScore

9.10

自引率

8.60%

发文量

217

审稿时长

3-6 weeks

期刊介绍： A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.