How long should older people take antidepressants to prevent relapse? Por quanto tempo os idosos devem tomar antidepressivos para evitar recaídas?

Patients with depressive disorder have a high risk of relapse after recovery from a depressive episode. Can the relapse of depressive disorder be prevented or delayed for older adults? This paper reviews the evidence from randomised clinical trials and open label trials of the effectiveness of maintenance antidepressant therapy for older adults with depressive disorder. It also examines the evidence for the effectiveness of psychosocial and psychotherapeutic interventions. The paper concludes with recommendations for clinical practice and future research.<br>Pacientes com transtorno depressivo apresentam alto risco de recorrência e recaída. É possível prevenir a recaída ou a recorrência do episódio depressivo ou retardá-lo em fases tardias da vida? Este artigo revisa ensaios clínicos aleatorizados e não-aleatorizados com o objetivo de estabelecer se o tratamento antidepressivo de manutenção reduz o risco de recaída e recorrência de depressão em idosos. O artigo também examina a evidência atualmente disponível sobre a eficácia das intervenções psicossociais e psicoterapêuticas. O artigo conclui com recomendações para a prática clínica e pesquisas futuras

An exploratory study of group mindfulness-based cognitive therapy for older people with depression

The benefits of a Mindfulness-Based Cognitive Therapy (MBCT) group for older people with recurrent and/or chronic depression were explored using a measure of mood (DASS-21) and well-being (Ryff Psychological Well-being Inventory). Thirteen participants started the study and outcome measures were recorded at baseline, post-MBCT group and at a 6-month follow-up. Although there was only a small sample size that had complete pre and post-group data (n = 9), improvements in depression and anxiety severity were noted and there was a significant improvement on ‘purpose in life’ and marginally significant improvement of ‘personal growth’, two of six domains on a measure of well-being. Participants were satisfied with the structure of the course but were less confident about committing to the daily practice after the group than pre-group. At 6 months follow-up, none of the group had relapsed into a major depressive episode. Further research with larger sample sizes and a control group to control for nonspecific therapeutic group factors is recommended