Study designs of evaluations included in the review
Controlled clinical trials, randomised controlled trials (RCTs), controlled before-and-after studies, and interrupted time series studies were all eligible for inclusion. To be included in the review, the retrieved studies had to meet the following quality criteria: relevant and interpretable data, concealed allocation of the participants, follow-up of at least 80 to 100% of the patients randomised, a baseline measurement, a reliable primary outcome measure, protection against contamination, and the blinded assessment of primary outcomes or use of an objective outcome measure.
Specific interventions included in the review
The studies had to be of cognitive and/or behavioural therapy, interpersonal psychotherapy, counselling, social support, or drug treatment.
Two studies included in the review were conducted solely in participants over the age of 60 years; these both assessed the effectiveness of psychiatric team care. The other three included studies were not specific to the elderly, and assessed the effectiveness of antidepressant medication. The specific drugs assessed were citalopram (20 and 34 mg), sertraline (83.5 and 144.6 mg), mianserin (78 mg) and fluoxetine (20 mg).
Participants included in the review
Studies were included if all the participants were over the age of 60 years. The participants had to be recruited from a sample of the general population or from primary care attenders. However, studies that were not elderly specific, but included some participants over the age of 60, were also included and analysed separately. Two of the five studies were therefore elderly specific, whilst the other three included participants aged from 18 to 79 years.
Outcomes assessed in the review
The primary outcome assessed was the change in the level of depression. This was assessed by the SHORTCARE score (1 study), a self-care questionnaire (1 study) and the MADRS score (3 studies).
How were decisions on the relevance of primary studies made?
One author initially selected the papers, based on the relevance of the primary studies.