title: Combined pharmacotherapy and psychotherapy as maintenance treatment for late-life depression: effects on social adjustment.
abstract: OBJECTIVE
  This study examined the effects of maintenance treatment for late-life depression on social adjustment. The authors hypothesized that elderly patients recovering from depression would have better social adjustment with medication and interpersonal psychotherapy than with medication or psychotherapy alone.
  
  
  METHODS
  Patients aged 60 and older recovering from recurrent major depression were randomly assigned to one of four treatments: nortriptyline and interpersonal psychotherapy, nortriptyline and clinic visits, placebo and psychotherapy, or placebo and clinic visits. The Social Adjustment Scale was administered every 3 months until illness recurrence. Combined treatment was compared to monotherapy on scores over 1 year among patients who remained in recovery (N=49).
  
  
  RESULTS
  Patients receiving nortriptyline and interpersonal psychotherapy maintained social adjustment, which declined in those receiving monotherapy.
  
  
  CONCLUSIONS
  Treatment of late-life depression with nortriptyline and psychotherapy is more likely to maintain social adjustment than treatment with either alone. Combination therapy improves not only duration but quality of wellness.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: Sati
authors.initials: S
authors.lastname: Mazumdar
authors.forename: Amy E
authors.initials: AE
authors.lastname: Begley
authors.forename: Cleon
authors.initials: C
authors.lastname: Cornes
authors.forename: Mark D
authors.initials: MD
authors.lastname: Miller
authors.forename: Stanley D
authors.initials: SD
authors.lastname: Imber
authors.forename: Ellen
authors.initials: E
authors.lastname: Frank
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D009661:Nortriptyline / Q000627:therapeutic use*; D009819:Office Visits; D010919:Placebos; D011613:Psychotherapy / Q000379:methods*; D012917:Social Adjustment; D016896:Treatment Outcome
chemical_list: D000929:Antidepressive Agents, Tricyclic; D010919:Placebos; D009661:Nortriptyline