BACKGROUND: Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. METHODS:Patients meeting DSM-IV criteria for an episode of major depressive disorder (n=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17-item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM-IV Personality Disorders. RESULTS: Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. CONCLUSION: With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians.
RCT Entities:
BACKGROUND: Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. METHODS:Patients meeting DSM-IV criteria for an episode of major depressive disorder (n=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17-item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM-IV Personality Disorders. RESULTS: Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. CONCLUSION: With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians.
Authors: E Frank; D J Kupfer; J M Perel; C Cornes; D B Jarrett; A G Mallinger; M E Thase; A B McEachran; V J Grochocinski Journal: Arch Gen Psychiatry Date: 1990-12
Authors: C F Reynolds; E Frank; J M Perel; S D Imber; C Cornes; M D Miller; S Mazumdar; P R Houck; M A Dew; J A Stack; B G Pollock; D J Kupfer Journal: JAMA Date: 1999-01-06 Impact factor: 56.272
Authors: M T Shea; P A Pilkonis; E Beckham; J F Collins; I Elkin; S M Sotsky; J P Docherty Journal: Am J Psychiatry Date: 1990-06 Impact factor: 18.112
Authors: J M Cyranowski; E Frank; E Winter; P Rucci; D Novick; P Pilkonis; A Fagiolini; H A Swartz; P Houck; D J Kupfer Journal: Psychol Med Date: 2004-05 Impact factor: 7.723
Authors: I Elkin; M T Shea; J T Watkins; S D Imber; S M Sotsky; J F Collins; D R Glass; P A Pilkonis; W R Leber; J P Docherty Journal: Arch Gen Psychiatry Date: 1989-11
Authors: Ellen Frank; Giovanni B Cassano; Paola Rucci; Andrea Fagiolini; Luca Maggi; Helena C Kraemer; David J Kupfer; Bruce Pollock; Robert Bies; Vishwajit Nimgaonkar; Paul Pilkonis; M Katherine Shear; Wesley K Thompson; Victoria J Grochocinski; Paolo Scocco; Joan Buttenfield; Rocco Nicola Forgione Journal: Clin Trials Date: 2008 Impact factor: 2.486