Cognitive, behavioural or cognitive-behavioural self-help interventions for subclinical depression in older adults: A systematic review and meta-analysis

Research output: Contribution to journalReview articlepeer-review


BACKGROUND: Subclinical depression is a risk factor for the development of major depression in older adults. We aimed to determine the effectiveness of pure self-help or self-help with minimal support to reduce depressive symptoms and to prevent the onset of major depression in this population.

METHODS: This was a systematic review and meta-analysis of trials that used self-administrated cognitive, behavioural or cognitive-behavioural interventions for older adults with subclinical depression compared to control groups. Medline, Embase, PsycInfo and Cochrane databases were searched for relevant studies.

RESULTS: We analysed eight trials involving 1449 participants. A small but significant effect favouring the intervention was found at short-term [d = 0.33; 95% CI (Confidence Interval): 0.20-0.47] and at long-term (d = 0.22; 95% CI: 0.04-0.40) for depressive symptoms. None of the studies looked at the preventive effect of self-help interventions in reducing the probability of a subsequent diagnosis of major depression.

LIMITATIONS: The low number of studies meant that it was not possible to test for publication bias. The absence of pre-published protocols for many of the studies meant that there is a possibility of selective reporting bias for some of the primary studies.

CONCLUSIONS: There is some evidence that cognitive-behavioural self-help interventions may reduce depressive symptoms in older adults with subclinical depression. However, no study examined whether the intervention had a preventative effect in reducing the likelihood of a subsequent diagnosis of major depression.

Original languageEnglish
Pages (from-to)384-390
Number of pages7
JournalJournal of affective disorders
Early online date22 Apr 2022
Publication statusPublished - 1 Jul 2022

Bibliographical note

© 2022 The Authors.


  • Aged
  • Cognition
  • Cognitive Behavioral Therapy
  • Depression/prevention & control
  • Depressive Disorder, Major/therapy
  • Health Behavior
  • Humans

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