Treating late-life depression with interpersonal psychotherapy in the primary care sector

Int J Geriatr Psychiatry. 2007 Feb;22(2):106-14. doi: 10.1002/gps.1700.

Abstract

Background: Interpersonal psychotherapy (IPT) is an empirically-validated intervention for treating late-life depression.

Objective: To determine the manner in which IPT is utilized by primary care physicians in relation to antidepressant medications.

Methods: The authors reviewed treatment logs prepared by care managers during the first 12 months of a patient's participation in the PROSPECT clinical trial to determine initial and longitudinal treatment patterns utilized by physicians, and clinical outcomes associated with initial treatment assignment.

Results: Primary care physicians in practices randomized to PROSPECT's intervention arm initially prescribed an antidepressant medication for 58% of eligible patients and referred only 11% of them to IPT. Over time, however, 27% of patients participated in IPT as monotherapy or augmentation therapy. Initial treatment assignment was not associated with depressive status at 4 and 12 months nor with suicidal ideation at 4, 8, and 12 months.

Conclusion: IPT is an effective treatment for late-life depression whose greater use by primary care physicians should be encouraged.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use
  • Combined Modality Therapy
  • Community Mental Health Services / methods*
  • Depressive Disorder / drug therapy
  • Depressive Disorder / therapy*
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Primary Health Care / methods
  • Psychiatric Status Rating Scales
  • Psychotherapy / methods*
  • Treatment Outcome

Substances

  • Antidepressive Agents