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J Gerontol B Psychol Sci Soc Sci. 2015 Jan;70(1):3-12. doi: 10.1093/geronb/gbt096. Epub 2013 Nov 10.

Comparison of the effectiveness of cognitive behavioral therapy for depression among older versus younger veterans: results of a national evaluation.

Author information

1
Mental Health Services, U.S. Department of Veterans Affairs Central Office, Washington, District of Columbia. Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. Bradley.Karlin2@va.gov.
2
Department of Psychiatry, Stanford University Medical Center, Palo Alto, California. VISN 21 Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, California.
3
VISN 4 Mental Illness Research, Education and Clinical Center, Philadelphia VA Medical Center, Pennsylvania. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Abstract

OBJECTIVES:

The effectiveness of cognitive behavioral therapy for depression (CBT-D) among older adults in routine clinical settings has received limited attention. The current article examines and compares outcomes of older versus younger veterans receiving CBT-D nationally.

METHOD:

Patient outcomes were assessed using the Beck Depression Inventory-II and World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised.

RESULTS:

A total of 764 veterans aged 18-64 and 100 veterans aged 65+ received CBT-D; 68.0% of older and 68.3% of younger patients completed all sessions or finished early due to symptom relief, and mean depression scores declined from 27.0 (standard deviation [SD] = 10.7) to 16.2 (SD = 12.4) in the older group and from 29.1 (SD = 11.2) to 17.8 (SD = 13.5) in the younger group. Within-group effect sizes were d = 1.01 for both groups. Significant increases in quality of life and therapeutic alliance were observed for both groups.

DISCUSSION:

CBT-D resulted in significant improvements in depression and quality of life among older patients. Outcomes and rate of attrition were equivalent to younger patients. Findings indicate that CBT-D is an effective and acceptable treatment for older veterans in real-world settings with often high levels of depression.

KEYWORDS:

Cognitive behavioral therapy; Department of Veterans Affairs; Depression; Geriatrics; Older adults; Veterans.

PMID:
24218096
DOI:
10.1093/geronb/gbt096
[Indexed for MEDLINE]

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