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

TY - JOUR

T1 - Cognitive, behavioural or cognitive-behavioural self-help interventions for subclinical depression in older adults

T2 - A systematic review and meta-analysis

AU - Corpas, Jorge

AU - Gilbody, Simon

AU - McMillan, Dean

N1 - © 2022 The Authors.

PY - 2022/7/1

Y1 - 2022/7/1

N2 - 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.

AB - 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.

KW - Aged

KW - Cognition

KW - Cognitive Behavioral Therapy

KW - Depression/prevention & control

KW - Depressive Disorder, Major/therapy

KW - Health Behavior

KW - Humans

U2 - 10.1016/j.jad.2022.04.085

DO - 10.1016/j.jad.2022.04.085

M3 - Review article

C2 - 35460732

SN - 0165-0327

VL - 308

SP - 384

EP - 390

JO - Journal of affective disorders

JF - Journal of affective disorders

ER -