Cognitive Behavioral Therapy versus Treatment As Usual with the depressed elderly, a comparison

Depression in old age is a frequent commonality in mental health with the
elderly and is associated with a several age related riskfactors. In treatment,
it is expected that it is necessary to be aware of these specific riskfactors.
In Dutch practice it is known that psychotherapy with the elderly is difficult
and that is important to be flexible in the use of techniques from several
theoretical movements. Integrative psychotherapie that is used in practice in
the Netherlands (Psycho-education, different parts from several therapies)
seems like a logical continuation on the interacting agerelated riskfactors and
their concequences. Systematic research to how these eclectic treatments work
is not present despite the frequent use in Dutch practice. In research, CBT is
found to be an effective psychotherapy for depression with the elderly. CBT
was investigated and compared to waitinglisttrials, placebotrials,
psychological treatment and anti-depressants. CBT does not include the unique
riskfactors with age. Systematic research on the effect of a psychotherapy that
focusses more on these unique age related riskfactors is not present.

This study contributes to determine if an integrated treatment for depressed
elderly could be of value for depressive elderly. When this is the case, the
systematically gathered data in this research, can be used and be part of the
protocol of treatment of depressed elderly in which at this time the integrated
treatment is not an option because of the lack of scientific proove for this
kind of treatment.

This study is a Randomized Controlled Trial (RCT); CBT and TAU wil be
investigated. Depressed elderly (>60 years) achieve treatment with a
CBT-protocol or a TAU-protocol. The study design exists of a measurement before
start of the treatment, after the start of the treatment and three months
following the treatment, so something can be said of the effect of the
treatment and the value of the treatment.

There are two trials; The CBT-trial and the TAU-trial.
Trial 1) CBT: This trial will be executed conform CBT-principels in practice
such as behavioral interventions, psycho-education, registration homework and
cognitive interventions.
Trial 2) TAU: This trial starts with a lot of explanation about the disorder
and psycho-education. Several techniques will be used in this therapy dependent
of the theme and riskfactors unique with age. CBT-Techniques will not be used
because there is minimal use of these techniques in the treatment as usual. At
this way the treatments can be optimally compared.

Minimal burden, there are know adverse events