Introduction: Different psychotherapeutic interventions for late-life depression (LLD) have been proposed, but their evaluation in large, multicenter trials is rare. Objective: The present study evaluated the efficacy of a specific cognitive behavioral therapy (CBT) for LLD (LLD-CBT) in comparison with a supportive unspecific intervention (SUI), both administered in a specialist psychiatric outpatient setting. Methods: In this randomized, controlled, parallel group trial, we recruited participants (≥60 years) with moderate to severe depression at 7 trial sites in Germany. Participants were randomly assigned to the LLD-CBT or SUI group. The primary outcome was depression severity at the end of treatment measured by change on the Geriatric Depression Scale (GDS). Secondary outcomes included change in observer-rated depression, anxiety, sleep ratings, and quality of life throughout the treatment phase and at 6-month follow-up. Results: Between October 1, 2018, and November 11, 2020, we randomly assigned 251 patients to either LLD-CBT (n = 126) or SUI (n = 125), of whom 229 provided primary-outcome data. There was no significant between-group difference in the change in GDS scores at the end of treatment (estimated marginal mean difference: −1.01 [95% CI: −2.88 to 0.86]; p = 0.287). Secondary analyses showed significant improvements in several outcomes after 8 weeks and at follow-up in both treatment arms. Conclusions: Our data suggest that LLD-specific CBT and a supportive unspecific treatment both provide clinical benefit in patients with moderate to severe LLD without evidence for superiority of LLD-CBT.
Psychother Psychosom

中文翻译：

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晚年抑郁症的认知行为疗法 (CBTlate)：多中心、随机、观察者盲法、对照试验的结果

简介：已经提出了针对晚年抑郁症（LLD）的不同心理治疗干预措施，但在大型多中心试验中对其进行评估的情况很少。目的：本研究评估了针对 LLD (LLD-CBT) 的特定认知行为疗法 (CBT) 与支持性非特异性干预 (SUI) 的疗效，两者均在专科精神病门诊环境中进行。方法：在这项随机、对照、平行组试验中，我们在德国 7 个试验点招募了患有中度至重度抑郁症的参与者（≥60 岁）。参与者被随机分配到 LLD-CBT 组或 SUI 组。主要结局是治疗结束时通过老年抑郁量表（GDS）的变化来衡量抑郁的严重程度。次要结局包括观察者评定的抑郁、焦虑、睡眠评定以及整个治疗阶段和 6 个月随访时的生活质量的变化。结果： 2018 年 10 月 1 日至 2020 年 11 月 11 日期间，我们将 251 名患者随机分配至 LLD-CBT ( n = 126) 或 SUI ( n= 125），其中 229 人提供了主要结果数据。治疗结束时 GDS 评分的变化没有显着的组间差异（估计边际平均差：-1.01 [95% CI：-2.88 至 0.86]；p = 0.287 ）。二次分析显示，8 周后和随访期间，两个治疗组的多项结果均显着改善。结论：我们的数据表明，LLD 特异性 CBT 和支持性非特异性治疗均可为中度至重度 LLD 患者提供临床益处，但没有证据表明 LLD-CBT 的优越性。
心理医生