Treatments for later-life depressive conditions: a meta-analytic comparison of pharmacotherapy and psychotherapy.
Treatments for later-life depressive conditions: a meta-analytic comparison of pharmacotherapy and psychotherapy.
复制标题
晚年抑郁症的治疗：药物治疗和心理治疗的荟萃分析比较。
DOI：
10.1176/ajp.2006.163.9.1493
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Lyness,JeffreyM
中科院分区：
文献类型：
--
作者：
Pinquart,Martin;Duberstein,PaulR;Lyness,JeffreyM
ObjectiveTo improve interventions for depressed older adults, data are needed on the comparative effects of pharmacotherapy versus psychotherapy. Given that most older adults with clinically significant depressive symptoms do not have major depression, data on treatments for minor depression and dysthymia are especially needed.MethodMeta-analysis was used to integrate the results of 89 controlled studies of treatments focused on acute major depression (37 studies) and other depressive disorders (52 studies conducted with mixed diagnostic groups, including patients with major depression, minor depression, and dysthymia). A total of 5,328 older adults received pharmacotherapy or psychotherapy in these studies.ResultsClinician-rated depression scores improved, on average, by 0.80 standard deviation (SD) units; self-rated depression scores improved by 0.76 SD units. Clinician-rated depression improved by 0.69 SD units in pharmacotherapeutic studies and by 1.09 SD units in psychotherapeutic studies. Self-rated depression improved by 0.62 SD units and 0.83 SD units, respectively. An interesting finding was the stronger improvements in clinician-rated depression among control subjects participating in medication studies, compared to those in psychotherapeutic studies.ConclusionsAvailable treatments for depression work, with effect sizes that are moderate to large. Comparisons of psychotherapy and pharmacotherapy must be interpreted with caution, in part because medication studies are more likely to use a credible active placebo, which may lead to smaller adjusted effect sizes in medication studies. Given that psychotherapy and pharmacotherapy did not show strong differences in effect sizes, treatment choice should be based on other criteria, such as contraindications, treatment access, or patient preferences.
