Cognitive-Behavioral Therapy in Geriatric Depression. Reply to Riskind, Beck, and Steer

Riskind, Beck, and Steer (1985)suggested that the changes we observed on the Beck Depression Inventory (BDI) in depressed geriatric patients treated with cognitive-behavioral (CB) group psychotherapy might have represented "significant clinical improvement" (p. 945) and demonstrated superiority for CB therapy over a psychodynamic approach. We acknowledge the BDI result and take advantage of the opportunity to question why this one scale might have been particularly sensitive in our study. Riskind, Beck, and Steer proposed that somatic items on the other rating instruments we used might not be valid in geriatric patients and thus might render those scales less sensitive. Reanalyses of our psychotherapy data and data from a placebo-controlled study of tricyclic antidepressants did not support this assertion. Somatic items proved to be sensitive to change in both studies.