Current data do not provide sufficient evidence to conclude whether psychotherapy helps older adults with depression, according to an article in Issue 1 (2008) Cochrane Database of Systematic Reviews.

Among the small number of patients studied, there were some signs that cognitive behavioral therapy could help older patients manage their depression, at least compared with patients waiting to start therapy.

Overall, however, "the findings do not provide strong support for psychotherapeutic treatments in the management of depression in older people," said lead review author Kenneth Wilson, of the University of Liverpool, England.

Wilson and colleagues reviewed 9 studies focused on use of psychotherapy for mild depression in some 700 older patients. Most studies involved cognitive behavioral therapy, which encourages patients to replace daily "unhealthy thoughts" with a more positive and realistic viewpoint. A few of the studies used psychodynamic therapy, which attempts to reveal unconscious thoughts and feelings that might be contributing to depression.

In 5 studies, patients who received cognitive behavioral therapy had significantly fewer symptoms of depression than those waiting to enter a therapy program.

However, most of the studies were small, with relatively few men and many patients who dropped out before the end of treatment. The patients ranged from mildly to severely depressed, and the treatments themselves were not standard between studies.

Despite stronger evidence of psychotherapy helping younger people, "all of these complications make it hard to say whether psychotherapy could be beneficial among older people," Wilson said.

Larger trials with standardized therapies might provide better information on efficacy.