Objective: To review treatment outcomes of older hospitalised patients with physical illnesses and factors associated with better outcome.
Design: Literature review.
Materials and Methods: Multiple database search for controlled studies of depression interventions for older people in general hospitals. Inclusion criteria were that the sample contained predominantly older participants, the intervention was provided by a psychogeriatric team or by a mental health professional. The methodological quality of the studies was rated according to criteria based upon Cochrane Collaboration Guidelines. A meta-analysis of treatment outcomes was undertaken where controlled data was available.
Results: Few controlled and naturalistic studies of depression in older hospitalised have demonstrated positive outcomes. Many studies are of poor - moderate quality which limits interpretation of the findings. The efficacy of antidepressant medication in older hospitalised patients with acute physical illnesses and depression remains unproven. There has been insufficient research involving non-pharmacologigal treatments.
Conclusion: Although depression in older patients in general hospital settings remains a major concern, the effectiveness of current treatment approaches is disappointing.
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