Talk therapy might be beneficial than medication for treating depression in older adults. Researchers from the VA Palo Alto Health Care System in California reviewed eight previous clinical trials, which found that psychological counseling was more effective, compared with the usual care from family doctors for older adults with depression. Usual care was up to each patient's primary care doctor, but typically involved antidepressant medication. The other patients received various forms of cognitive-behavioural therapy in combination with medication in some studies, and as a stand-alone therapy in others. It was found that latter patients did better than those given routine treatment. But the most positive results came from two studies that used an interdisciplinary approach meaning mental health providers worked along with patients' primary care doctors to design their treatment. Previous studies have found that older adults prefer to seek depression therapy from their primary care doctors but, at the same time, they also favour talk therapy over antidepressants. Still, only two of the eight studies assessed cognitive-behavioural therapy as a stand-alone treatment for depression, and there needs to be more research into using it as a first-line therapy. There is already substantial evidence that, in contrast to traditional clinical lore, older adults do not prefer drugs over psychological counseling. Older adults are on a lot of medications already, and usually are trying to work with their doctors to reduce the number of medications they're on, and not increase. What's more, older adults' depression is often related to physical illnesses and disabilities the very things for which they see their primary care doctors. And these depression symptoms not only stem from medical conditions, but can also exacerbate them. Given the reciprocal relationship of health problems and depression in older adults, providing integrated care for physical and mental health problems in the same setting seems unarguably indicated.
Health Psychology,
November 2006