Article

A controlled evaluation of monthly maintenance Interpersonal Psychotherapy in late-life depression with varying levels of cognitive function

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
International Journal of Geriatric Psychiatry (Impact Factor: 3.09). 11/2008; 23(11):1110-3. DOI: 10.1002/gps.2031
Source: PubMed

ABSTRACT To evaluate the effect of maintenance Interpersonal Psychotherapy (IPT) on recurrence rates and time to recurrence of major depression in elderly patients with varying levels of cognitive function.
Two-year maintenance study of monthly maintenance IPT vs supportive clinical management (CM) in remitted depressed elderly who were participants in a previously reported placebo-controlled study of maintenance paroxetine and IPT (Reynolds et al., 2006). We used Cox regression analysis to test interactions between cognitive status (Dementia Rating Scale score) and treatment (IPT, CM) with respect to recurrence of major depression.
We observed a significant interaction between cognitive status and treatment: lower cognitive performance was associated with longer time to recurrence in IPT than in CM (58 weeks vs 17 weeks) (HR = 1.41 [95% CI = 1.04, 1.91], p = 0.03). Subjects with average cognitive performance showed no effect of maintenance IPT vs CM on time to recurrence (38 vs 32 weeks, respectively).
Monthly maintenance IPT confers protection against recurrence of major depression in elders with lower cognitive functioning.

Download full-text

Full-text

Available from: Jennifer Q Morse, Aug 31, 2015
0 Followers
 · 
77 Views
  • Source
    • "IPT appears to have clinical utility in treating late-life depression119 and potential in combination with antidepressant medication.120 More recent analyses have indicated that maintenance IPT is not as effective as supportive clinical management in sustaining gains made in health-related quality of life,121 but it may lower the risk of recurrence of major depression in older adults who have lower cognitive functioning.122 Although it remains a promising treatment for depression in later life, IPT continues to lack the empirical requisites for addition to the evidence-based intervention listing.86,123 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Less than half of older adults with depression achieve remission with antidepressant medications, and rates of remission are even poorer for those with comorbid conditions. Psychosocial interventions have been effective in treating geriatric depression, either alone or better yet, in combination with antidepressant medications. Traditional strategies for nonpharmacological treatment of late-life depression do not specifically address the co-occurring cognitive impairment and disability that is prevalent in this population. Newer therapies are recognizing the need to simultaneously direct treatment efforts in late-life depression towards the triad of depressive symptoms, cognitive dysfunction, and functional disability that is so often found in geriatric depression, and this comprehensive approach holds promise for improved treatment outcomes.
    Clinical Interventions in Aging 11/2010; 5:323-31. DOI:10.2147/CIA.S9088 · 1.82 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To identify and discuss recent research studies that propose innovative psychosocial interventions in old age psychiatry. Studies have shown that cognitive training research for healthy elderly has advanced in several ways, particularly in the refinement of study design and methodology. Studies have included larger samples and longer training protocols. Interestingly, new research has shown changes in biological markers associated with learning and memory after cognitive training. Among mild cognitive impairment patients, results have demonstrated that they benefit from interventions displaying cognitive plasticity.Rehabilitation studies involving dementia patients have suggested the efficacy of combined treatment approaches, and light and music therapies have shown promising effects. For psychiatric disorders, innovations have included improvements in well known techniques such as cognitive behavior therapy, studies in subpopulations with comorbidities, as well as the use of new computer-aided resources. Research evidence on innovative interventions in old age psychiatry suggests that this exciting field is moving forward by means of methodological refinements and testing of creative new ideas.
    Current opinion in psychiatry 08/2009; 22(6):527-31. DOI:10.1097/YCO.0b013e3283304128 · 3.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: I nterest in psychosocial treatment as non-pharmacologic treatment in the elderly has been in-creasing, and this treatment has became an important therapeutic approach for the following common psychiatric disorders: depressive disorder, anxiety disorder, some psychological con-ditions, and some cognitive disorders. Some examples of the psychosocial treatments frequently used with older people with psychiatric disorders are cognitive behavior therapy, interpersonal therapy, individual psychotherapy, reality orientation, validation therapy, reminiscence therapy, and cognitive training. Those treatment options should be used carefully in light of individual needs and optimal objectives for the elderly and their caregivers. It is crucial for the clinician to understand the characteristics and clinical applications of each psychosocial treatment for the el-derly in particular. Further studies are needed to demonstrate the feasibility and effectiveness of old and new psychosocial treatment modalities for older people with psychiatric disorders. Psy-chosocial treatments are very important with or without pharmacological treatment in the elderly with psychiatric problems. Clinician should become familiar with various psychosocial treatments.
    Journal of the Korean Medical Association 01/2010; 53(11). DOI:10.5124/jkma.2010.53.11.984 · 0.18 Impact Factor
Show more