Cognitive therapy with elderly people.

Following an expansion in the range of psychological treatments used to treat psychiatric disorders in younger adults there is now increasing interest in the use of these techniques with older patients. This is accompanied by an awareness of the often poor prognosis of emotional disorders in older people, particularly depressive illness, and a need to develop effective interventions. Up to two-thirds of depressed elderly patients may fail to achieve a good outcome despite the use of conventional physical treatments and these treatments may themselves present problems because of concurrent medical problems. There is, therefore, a need to expand the range of suitable interventions. The recent US National Institute of Health consensus development conference [1] highlighted the need for the continued development and evaluation of psychosocial interventions, with particular reference to the way in which such treatments may complement or provide alternatives to physical treatments. Treatments for older patients should also address physical symptoms, whether these are the result of physical or psychological disorder.