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: 2.87). 11/2008; 23(11):1110-3. DOI: 10.1002/gps.2031
Source: PubMed


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.

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    • "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 "
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