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. 2017 Mar;4(1):1-12.
doi: 10.1007/s40501-017-0100-6. Epub 2017 Feb 8.

Psychosocial Treatment Options for Major Depressive Disorder in Older Adults

Brenna N Renn  1 , Patricia A Areán  1
Affiliations

Psychosocial Treatment Options for Major Depressive Disorder in Older Adults

Brenna N Renn et al. Curr Treat Options Psychiatry. 2017 Mar.

Abstract

Late-life depression (LLD) is a public health concern with deleterious effects on overall health, cognition, quality of life, and mortality. Although LLD is relatively common, it is not a normal part of aging and is often under-recognized in older adults. However, psychotherapy is an effective treatment for LLD that aligns with many patients' preferences and can improve health and functioning. This review synthesized the current literature on evidence-based psychotherapies for the treatment of depression in older adults. Findings suggest that active, skills-based psychotherapies (cognitive behavioral therapy [CBT] and problem-solving therapy [PST]) may be more effective for LLD than non-directive, supportive counseling. PST may be particularly relevant for offsetting skill deficit associated with LLD, such as in instances of cognitive impairment (especially executive dysfunction) and disability. Emerging treatments also consider contextual factors to improve treatment delivery, such as personalized care, access, and poverty. Tele-mental health represents one such exciting new way of improving access and uptake of treatment by older adults. Although these strategies hold promise, further investigation via randomized controlled trials and comparative effectiveness are necessary to advance our treatment of LLD. Priority should be given to recruiting and training the geriatric mental health workforce to deliver evidence-based psychosocial interventions for LLD.

Keywords: Geriatric psychiatry; geropsychology; late-life depression; older adults; psychotherapy; treatment.

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Conflict of interest statement

Conflict of Interest Dr. Renn has nothing to disclose. Dr. Areán’s research is funded by NIMH and United Health Care. Dr. Areán is also a member of the American Psychological Association Advisory Board for Treatment Guidelines, and also works with the UW AIMS Center, designing educational programs to train care managers in evidence-based psychotherapy, including problem solving treatment, behavioral activation, cognitive processing therapy, and cognitive behavioral therapy for anxiety and insomnia.

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