Factsheet: Ouderen

Cognitieve gedragstherapie (CGT) is een behandelmethodiek die effectief en goed toepasbaar is bij ouderen (65+). Hoewel er – in vergelijking met volwassenen – minder onderzoek is gedaan naar de effectiviteit van CGT bij ouderen, stemmen de resultaten optimistisch. Deze factsheet zet de evidentie op een rij voor verschillende psychische problemen en geeft handvatten voor het toepassen van CGT bij ouderen.

Deze factsheet is ontwikkeld door Corgé Borghouts en Dorine van Driel in samenwwerking met Gert-Jan Hendriks, Arjan Videler, Claudia Disselhorst, Diniek Kanis en Nicole Hooiveld van de sectie Ouderen.  

Meer informatie

Voor meer informatie zie de Zorgstandaard Ouderen met psychische aandoeningen.

Leestips

• Boek: Met de jaren – Waarom het wel zin heeft om ouderen met psychische problemen te behandelen. Videler, A. C., & Wilting, R. (2023)
• Artikel: Psychotherapie bij ouderen: heeft dat zin? Videler, A.C. (2024)
• Serie CGT-artikelen in het themanummer Oudere volwassenen in het Tijdschrift voor gedragstherapie en cognitieve therapie (2021)

Bronnen

Prevalentie

• ten Have, M., Tuithof, M., van Dorsselaer, S., Schouten, F., Luik, A. I., & de Graaf, R. (2023). Prevalence and trends of common mental disorders from 2007-2009 to 2019-2022: Results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID-19 pandemic. World Psychiatry. https://doi.org/10.1002/wps.21087
• Andreas, S., Schulz, H., Volkert, J., Dehoust, M., Sehner, S., Suling, A., Ausín, B., Canuto, A., Crawford, M., Ronch, C. D., Grassi, L., Hershkovitz, Y., Muñoz, M., Quirk, A., Rotenstein, O., Santos-Olmo, A. B., Shalev, A., Strehle, J., Weber, K., … Härter, M. (2017). Prevalence of mental disorders in elderly people: The European MentDis_ICF65+ study. The British Journal of Psychiatry. https://doi.org/10.1192/bjp.bp.115.180463
• Hendriks, G.-J., & Oude Voshaar, R. C. (2021). Diagnostiek bij ouderen met angststoornissen en depressies. Gedragstherapie. https://www.tijdschriftgedragstherapie.nl/inhoud/tijdschrift_artikel/TG-2021-4-3/Diagnostiek-bij-ouderen-met-angststoornissen-en-depressies
• Grenier, S., Préville, M., Boyer, R., O’Connor, K., Béland, S.-G., Potvin, O., Hudon, C., Brassard, J., & Scientific Committee of the ESA Study. (2011). The impact of DSM-IV symptom and clinical significance criteria on the prevalence estimates of subthreshold and threshold anxiety in the older adult population. The American Journal of Geriatric Psychiatry. https://doi.org/10.1097/JGP.0b013e3181ff416c
• Hohls, J. K., König, H.-H., Raynik, Y. I., & Hajek, A. (2018). A systematic review of the association of anxiety with health care utilization and costs in people aged 65 years and older. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2018.02.011
• Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., Abraham, J., Ackerman, I., Aggarwal, R., Ahn, S. Y., Ali, M. K., Alvarado, M., Anderson, H. R., Anderson, L. M., Andrews, K. G., … Memish, Z. A. (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. https://doi.org/10.1016/S0140-6736(12)61729-2
• Penders, K. A. P., Peeters, I. G. P., Metsemakers, J. F. M., & van Alphen, S. P. J. (2020). Personality disorders in older adults: A review of epidemiology, assessment, and treatment. Current Psychiatry Reports. https://doi.org/10.1007/s11920-020-1133-x
• Everaerd, D. S. (2024). Ga mee met uw tijd: Denk ook aan verslaving bij uw oudere patiënt. Tijdschrift voor Psychiatrie. https://www.tijdschriftvoorpsychiatrie.nl
• Hilderink, P. H., Collard, R., Rosmalen, J. G. M., & Oude Voshaar, R. C. (2013). Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups: A systematic review. Ageing Research Reviews. https://doi.org/10.1016/j.arr.2012.04.004
• Reynolds, K., Pietrzak, R. H., Mackenzie, C. S., Chou, K. L., & Sareen, J. (2016). Post-Traumatic Stress Disorder across the adult lifespan: Findings from a nationally representative survey. The American Journal of Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2015.11.001
• Heydarikhayat, S., Kazeminia, M., Heydarikhayat, N., Rezaei, M., Heydarikhayat, N., & Ziapour, A. (2024). Prevalence of obsessive-compulsive disorder in the older person: A systematic review and meta-analysis. BMC Geriatrics. https://doi.org/10.1186/s12877-024-05440-0
• Vasiliadis, H.-M., Pitrou, I., Lamoureux-Lamarche, C., Grenier, S., Nguyen, P. V.-Q., & Hudon, C. (2022). Factors associated with late-life psychosis in primary care older adults without a diagnosis of dementia. Social Psychiatry and Psychiatric Epidemiology. https://doi.org/10.1007/s00127-021-02132-7

Probleem

• Mohlman, J. (2012). A community based survey of older adults’ preferences for treatment of anxiety. Psychology and Aging. https://doi.org/10.1037/a0023126
• Hetlevik, Ø., Garre-Fivelsdal, G., Bjorvatn, B., Hjørleifsson, S., & Ruths, S. (2019). Patient-reported depression treatment and future treatment preferences: An observational study in general practice. Family Practice. https://doi.org/10.1093/fampra/cmz026
• Gellert, P., Lech, S., Kessler, E.-M., Herrmann, W., Döpfmer, S., Balke, K., Oedekoven, M., Kuhlmey, A., & Schnitzer, S. (2021). Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: Two cohorts of a nationwide survey. BMC Health Services Research. https://doi.org/10.1186/s12913-021-06384-6
• Pettit, S., Qureshi, A., Lee, W., Stirzaker, A., Gibson, A., Henley, W., & Byng, R. (2017). Variation in referral and access to new psychological therapy services by age: An empirical quantitative study. The British Journal of General Practice. https://doi.org/10.3399/bjgp17X691361

Effectiviteit

• Hendriks, G.-J., Janssen, N., Robertson, L., Balkom, A. J. van, Zelst, W. H. van, Wolfe, S., Voshaar, R. C. O., & Uphoff, E. (2024). Cognitive behavioural therapy and third‐wave approaches for anxiety and related disorders in older people—Hendriks, G-J – 2024 | Cochrane Library. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007674.pub3
• Hendriks, G.-J., Janssen, N., van den Berg, R., & Oude Voshaar, R. C. (2021). Cognitieve gedragstherapie bij ouderen met angst- en dwangstoornissen en PTSS. Gedragstherapie. https://www.tijdschriftgedragstherapie.nl/inhoud/tijdschrift_artikel/TG-2021-4-8/Cognitieve-gedragstherapie-bij-ouderen-met-angst-en-dwangstoornissen-en-PTSS
• Cuijpers, P., van Straten, A., & Smit, F. (2006). Psychological treatment of late-life depression: A meta-analysis of randomized controlled trials. International Journal of Geriatric Psychiatry. https://doi.org/10.1002/gps.1620
• Davison, T. E., Bhar, S., Wells, Y., Owen, P. J., You, E., Doyle, C., Bowe, S. J., & Flicker, L. (2024). Psychological therapies for depression in older adults residing in long‐term care settings. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD013059.pub2
• Dinnen, S., Simiola, V., & Cook, J. M. (2015). Post-traumatic stress disorder in older adults: A systematic review of the psychotherapy treatment literature. Aging & Mental Health. https://doi.org/10.1080/13607863.2014.920299
• Thorp, S. R., Glassman, L. H., Wells, S. Y., Walter, K. H., Gebhardt, H., Twamley, E., Golshan, S., Pittman, J., Penski, K., Allard, C., Morland, L. A., & Wetherell, J. (2019). A randomized controlled trial of prolonged exposure therapy versus relaxation training for older veterans with military-related PTSD. Journal of Anxiety Disorders. https://doi.org/10.1016/j.janxdis.2019.02.003
• Knaevelsrud, C., Böttche, M., Pietrzak, R. H., Freyberger, H. J., & Kuwert, P. (2017). Efficacy and feasibility of a therapist-guided internet-based intervention for older persons with childhood traumatization: A randomized controlled trial. The American Journal of Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2017.02.024
• Lely, J. C. G., Knipscheer, J. W., Moerbeek, M., Ter Heide, F. J. J., van den Bout, J., & Kleber, R. J. (2019). Randomised controlled trial comparing narrative exposure therapy with present-centred therapy for older patients with post-traumatic stress disorder. The British Journal of Psychiatry. https://doi.org/10.1192/bjp.2019.59
• Sonis, J., & Cook, J. M. (2019). Medication versus trauma-focused psychotherapy for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Psychiatry Research. https://doi.org/10.1016/j.psychres.2019.112637
• Hendriks, G.-J., Kampman, M., Keijsers, G. P. J., Hoogduin, C. A. L., & Voshaar, R. C. O. (2014). Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: A comparison with younger patients. Depression and Anxiety. https://doi.org/10.1002/da.22274
• Cuijpers, P., Karyotaki, E., Eckshtain, D., Ng, M. Y., Corteselli, K. A., Noma, H., Quero, S., & Weisz, J. R. (2020). Psychotherapy for depression across different age groups: A systematic review and meta-analysis. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2020.0164
• Werson, A. D., Meiser-Stedman, R., & Laidlaw, K. (2022). A meta-analysis of CBT efficacy for depression comparing adults and older adults. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2022.09.020
• Gielkens, E. M. J., De Jongh, A., Sobczak, S., Rossi, G., Van Minnen, A., Voorendonk, E. M., Rozendaal, L., & Van Alphen, S. P. J. (2021). Comparing intensive trauma-focused treatment outcome on PTSD symptom severity in older and younger adults. Journal of Clinical Medicine. https://doi.org/10.3390/jcm10061246
• Van Dijk, S., & Veenstra, M. (2021). Schematherapie bij ouderen. Gedragstherapie. https://www.tijdschriftgedragstherapie.nl/inhoud/tijdschrift_artikel/TG-2021-4-10/Schematherapie-bij-ouderen
• Veenstra-Spruit, M. S., Bouman, R., Van Dijk, S. D., Van Asselt, A. D., Van Alphen, S. P., Veenstra, D. H., De Ruiter, M., Troost, S. E., Lammers, M. W., Vulker, F., Smeets-Janssen, M. M., Van Den Brink, R. H., & Voshaar, R. C. O. (2024). Group schema therapy combined with psychomotor therapy for older adults with a personality disorder: An open-label, multicentre, randomised controlled trial. The Lancet Healthy Longevity. https://doi.org/10.1016/S2666-7568(24)00001-1
• Hanssen, D., & van Driel, D. (2021). Cognitieve gedragstherapie bij persisterende SOLK op latere leeftijd. Gedragstherapie. https://www.tijdschriftgedragstherapie.nl/inhoud/tijdschrift_artikel/TG-2021-4-9/Cognitieve-gedragstherapie-bij-persisterende-SOLK-op-latere-leeftijd
• van Driel, D., Hilderink, P., de Bakker, S., Benraad, C., & Speckens, A. (2007). Cognitieve gedragstherapie bij ouderen met onverklaarde lichamelijke klachten. Gedragstherapie. https://doi.org/10.1007/BF03056853
• Arcadepani, F. B., & Fidalgo, T. M. (2023). Substance use among older adults: A review of the literature. Journal of Addictive Diseases. https://doi.org/10.1080/10550887.2022.2109923
• Boumans, J., van de Mheen, D., Crutzen, R., Dupont, H., Bovens, R., & Rozema, A. (2022). Understanding how and why alcohol interventions prevent and reduce problematic alcohol consumption among older adults: A systematic review. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph19063188
• Dou, C., Rebane, J., & Bardal, S. (2019). Interventions to improve benzodiazepine tapering success in the elderly: A systematic review. Aging & Mental Health, 23(4), 411-416. https://doi.org/10.1080/13607863.2017.1423030
• Gould RL, Coulson MC, Patel N, Highton-Williamson E, Howard RJ. Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials. The British Journal of Psychiatry. https://doi.org/10.1192/bjp.bp.113.126003
• Multidisciplinaire richtlijn Stoornissen in het gebruik van alcohol (2023). Federatie Medisch Specialisten.https://richtlijnendatabase.nl/richtlijn/stoornissen_in_het_gebruik_van_alcohol_2023/startpagina_-_stoornissen_in_het_gebruik_van_alcohol_2023.html

Aandachtspunten

• Disselhorst, C., & Borghouts, C. (2017). Mediatieve cognitieve gedragstherapie. In Handboek ouderenpsychologie. De Tijdstroom. https://www.boom.nl/psychiatrie/100-8166_Handboek-ouderenpsychologie
• Kadri, A., Leddy, A., Gracey, F., & Laidlaw, K. (2022). Wisdom enhancement and life skills to augment CBT outcomes for depression in later life: A series of N-of-1 trials. Behavioural and Cognitive Psychotherapy. https://doi.org/10.1017/S1352465822000224