Randomized Trial of Weekly, Twice-Monthly, and Monthly Interpersonal Psychotherapy as Maintenance Treatment for Women With Recurrent Depression

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
American Journal of Psychiatry (Impact Factor: 12.3). 06/2007; 164(5):761-7. DOI: 10.1176/appi.ajp.164.5.761
Source: PubMed


The authors sought to determine whether a greater frequency of interpersonal psychotherapy (IPT) sessions during maintenance treatment has a greater prophylactic effect than a previously validated once-a-month treatment.
A total of 233 women 20-60 years of age with recurrent unipolar depression were treated in an outpatient research clinic. After participants had achieved remission with weekly IPT or, if required, with weekly IPT plus antidepressant pharmacotherapy, they were randomly assigned to weekly, twice-monthly, or monthly maintenance IPT monotherapy for 2 years or until a recurrence of their depression occurred.
Among participants who remitted with IPT alone and entered maintenance treatment (N=99), 19 (26%) of the 74 who remained in the study throughout the 2-year maintenance phase experienced a recurrence of depression. Among participants who required the addition of a selective serotonin reuptake inhibitor to achieve remission (N=90), 32 (36%) sustained that remission through continuation treatment and drug discontinuation and began maintenance treatment; of these, 13 (50%) of the 26 who remained in the study throughout the maintenance phase experienced a recurrence. Survival analysis of time to recurrence by randomized treatment frequency showed no effect on recurrence-free survival in either treatment subgroup.
These results suggest that maintenance IPT, even at a frequency of only one visit per month, is a good method of prophylaxis for women who can achieve remission with IPT alone. In contrast, among those who require the addition of pharmacotherapy, IPT monotherapy represents a significantly less efficacious approach to maintenance treatment.

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Available from: Paul A Pilkonis, Sep 03, 2015
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    • "These data suggest that intervention focused around the IPT problem areas of role transition and interpersonal deficits would be effective at both treating and preventing future depression in emerging adults. In addition to acute intervention, research supports IPT as maintenance treatment for recurrence prevention (Frank et al., 2007, 1990) and within university-based prevention programs (Sheets et al., 2013). These findings also relate to core elements of the behavioral activation (BA) approach to depression treatment. "
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    ABSTRACT: Understanding how persistent interpersonal difficulties distinctly affect the course of major depressive disorder (MDD) during emerging adulthood is critical, given that early experiences impact future coping resources and functioning. Research on stress and MDD has mostly concentrated on stressful life events, while chronic stress largely has not been explored. The present study examined interpersonal (intimate relationship, close friendships, social life, family relationships) and noninterpersonal (academic, work, financial, personal health, and family members' health) domains of chronic stress as time-varying predictors of depressive recurrence in emerging adults. Baseline assessments identified previously depressed emerging adults (N = 119), who subsequently completed 6-month, 12-month and 18-month follow-up interviews to determine chronic stress experiences and onset of new major depressive episodes. Survival analyses indicated that time-varying total chronic stress and chronic interpersonal stress predicted higher risk for depression recurrence; however, chronic noninterpersonal stress was not associated with recurrence. Intimate relationship stress, close friendship stress, family relationship stress, personal health, and family members' health independently predicted MDD recurrence, over and above well-established depression risk factors of dysfunctional cognitions and personality disorder symptoms. Evidence that interpersonal stress could have substantial impact on course of depression is consistent with theories of emerging adulthood, a time when young people are individuating from the family and experiencing significant social transition.
    Behaviour Research and Therapy 12/2014; 63:36-42. DOI:10.1016/j.brat.2014.09.001 · 3.85 Impact Factor
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    • "However, the long term effect of IPT has not been tested extensively yet. Up until now it has only been tested as a maintenance treatment [36,37], and the question remains whether IPT also has an enduring effect that remains after therapy is finished. This question should be further explored. "
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    Trials 06/2011; 12(1):150. DOI:10.1186/1745-6215-12-150 · 1.73 Impact Factor
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    • " and the combination of the two approaches . On a short - term acute basis , various psycho - therapies were found to be effective , including cognitive behavioral therapy . For long - term treatment , cognitive behavioral therapy and interpersonal psychotherapy were shown to have lasting benefits after treatment terminated ( Dobson et al . 2008 ; Frank et al . 2007 ; Vittengl et al . 2007 ) . Different studies on different types of depressed popula - tions using different psychotherapies confirm the value of cognitive behavioral therapy , but also indicate that in some cases , its behavioral component is most efficacious . As well , the value of pharmacotherapy in the treatment of chronic depressi"
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