+AA
En
Retour
Article pour les cliniciens

L'efficacité des interventions non pharmacologiques chez les personnes âgées souffrant de troubles dépressifs: une revue systématique.



  • Apostolo J
  • Bobrowicz-Campos E
  • Rodrigues M
  • Castro I
  • Cardoso D
Int J Nurs Stud. 2016 Jun;58:59-70. doi: 10.1016/j.ijnurstu.2016.02.006. Epub 2016 Feb 17. (Review)
PMID: 27087298
Lire le résumé
Disciplines
  • - Gériatrie
    Relevance - 7/7
    Intérêt médiatique  - 5/7
  • Médecine familiale (MF)/Médecine générale (MG)
    Relevance - 7/7
    Intérêt médiatique  - 4/7
  • Médecine interne générale - Soins primaires
    Relevance - 7/7
    Intérêt médiatique  - 4/7
  • Psychiatrie
    Relevance - 6/7
    Intérêt médiatique  - 5/7
  • - MF/MG/Santé mentale
    Relevance - 5/7
    Intérêt médiatique  - 5/7

Résumé (en anglais)

BACKGROUND: It is widely acknowledged that mental health disorders are common in older adults and that depression is one of the most serious threats to the mental health of older adults. Although best practice guidelines point out that moderate to severe depression should be approached with pharmacotherapy together with complementary therapies, the use of antidepressant drugs in older adults has various disadvantages, such as long response time, side effects, potential risk of dependency and tolerance, poor compliance rates and high probability of drug interactions. In addition, qualitative studies of depressed people with a chronic illness have indicated that both patients and healthcare professionals prefer a psychosocial treatment for depression over a pharmacological one.

OBJECTIVE: This review aimed to identify and synthesize the best available evidence related to the effectiveness of non-pharmacological interventions for older adults with depressive disorders.

DESIGN: Systematic review of studies with any experimental design considering non-pharmacological interventions for older adults with depressive disorders.

DATA SOURCES: An initial search of MEDLINE and CINAHL was undertaken, followed by a second search for published and unpublished studies, from January 2000 to March 2012, of major healthcare-related electronic databases. Studies in English, Spanish and Portuguese were included in the review.

REVIEW METHODS: This review considered studies that included adult patients, aged over 65 years with any type of depressive disorder, regardless of comorbidities and any previous treatments, but excluded those with manic or psychotic episodes/symptoms. All studies that met the inclusion criteria were assessed for methodological quality by two independent reviewers using a standardized critical appraisal checklist for randomized and quasi-randomized controlled studies from the Joanna Briggs Institute. Data extraction was also conducted by two independent reviewers based on the Joanna Briggs Institute data extraction form for experimental studies.

RESULTS: Twenty-three studies met the inclusion criteria. Of those, seventeen were excluded after critical appraisal of methodological quality and six were included in this review. These studies included 520 participants and described cognitive behavior therapy, competitive memory training, reminiscence group therapy, problem-adaptation therapy, and problem-solving therapy in home care. Evidence suggests that all these interventions reduce depressive symptoms.

CONCLUSIONS: According to evidence, non-pharmacological interventions had positive effects on improving patients' depression and may be useful in practice. However, due to the diversity of interventions and the low number of studies per intervention included in this systematic review, evidence is not strong enough to produce a best practice guideline.


Commentaires cliniques (en anglais)

Geriatrics

As mentioned by the authors, the studies were quite different in their patient groups, interventions and exclusion criteria. Also, one is not able extrapolate this to wider population.

Voulez-vous savoir ce que lisent les professionnels? Inscrivez-vous pour accéder gratuitement à tous les contenus professionnels.

S'inscrire
Intéressés par les recherches sur le vieillissement? Inscrivez-vous aux alertes par courriel.

Le soutien au Portail est largement assuré par l’Initiative Labarge sur le vieillissement optimal. AGE-WELL est un partenaire contributeur. Aidez-nous à continuer à fournir un accès direct et facile à des informations fondées sur des données probantes sur des enjeux de santé et sociaux pour vous aider à rester en bonne santé, actif et engagé en vieillissant. Faites un don dès aujourd'hui.

La traduction française du contenu destiné au grand public sur ce site Web est soutenue en partie par le Réseau québécois de recherche sur le vieillissement.
© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Conditions d'utilisation