Evidence-based psychotherapeutic interventions for geriatric depression.

In 1991, the National Institutes of Health consensus statement on the treatment of late-life depression ranked psychotherapy as third in a line of treatment options, with antidepressant medication first and electroconvulsive therapy second, indicating that there was insufficient evidence to recommend psychotherapy as a first-line treatment for depression in older adults [1]. Since that time, numerous articles have been written reviewing the evidence base for psychotherapy research in older adults and four meta-analyses of existing trials have been conducted (Table 1) [2–26]. In addition, several randomized clinical trials meeting guideline recommendations for evidencebased interventions [27] have evaluated the efficacy of psychotherapy as a treatment for late-life depression (Table 2) [28–43]. Most of these studies have focused on the evaluation of cognitive-behavioral therapy (CBT), brief dynamic therapy (BDT), interpersonal psychotherapy (IPT), reminiscence therapy (RT), and the combination of these interventions with medication management. This review systematically evaluates the evidence base for psychotherapy as an empirically supported treatment of late-life depression and is an update of the present authors’ recent review of the literature [23].