Effectiveness of Treatments of Depression in Older Ambulatory Patients

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Abstract
FIVE PUBLISHED meta-analyses of treatments of depression in the elderly (3 on antidepressants,1-3 1 on psychosocial therapies,4 and 1 on both5) and a consensus conference6 have concluded that pharmacological and psychosocial treatments are effective. However, these reviews included many studies of psychiatric inpatients who usually have more severe depression than that seen in ambulatory settings and did not compare pharmacological and psychological approaches. Therefore, we performed this meta-analysis to determine the effectiveness of acute-phase pharmacological and psychological treatments of depression in the older ambulatory population. We included studies of ambulatory patients conducted in outpatient, community, and nursing home settings.