Management of depression in older people with osteoarthritis: A systematic review

Objectives: Osteoarthritis (OA) is the most common form of arthritis, and depressive symptoms are common in older people with arthritic pain. However, relatively little attention has been given to the efficacy of interventions that may be beneficial for older people with OA with concomitant depressive symptoms. Methods: The aim of this review was to evaluate data from clinical trials testing the effectiveness of various interventions for older patients suffering from OA and depression. Systematic searches were conducted on MEDLINE, CINAHL, Scopus, PsychInfo, Web of Knowledge and Pubmed (January 1990-July 2009). Results: Fourteen studies were identified and examined. Interventions highlighted in these studies were: patient education programmes (N = 3); cognitive behavioural therapy (CBT) (N = 2); depression care and pharmacological intervention (N = 2); and exercise therapy (N = 7). 11 out of 14 interventions showed some improvement in patients' depressive symptoms in the short term. Three of the interventions did not affect depressive symptoms on patients with OA. Conclusions: There was some evidence to suggest that the intervention of CBT, integrated depression care management and exercise therapy were associated with reduced depressive symptoms in the short term. However, the long-term benefits of depression management in patients with OA with co-morbid depression are unknown. Future well-controlled clinical trials are needed.