Interpersonal psychotherapy as augmentation treatment in depressed elderly responding poorly to antidepressant drugs: a case series.
BACKGROUND
Medication is often the first choice in the treatment of depression, even though large numbers of depressed patients do not respond to antidepressant drugs or fail to achieve symptom remission or recovery. Generally, other drugs, rather than other therapeutic approaches such as psychotherapy, are used as augmentation treatment. This applies in particular to elderly patients. The aim of this work is to assess whether augmentation with interpersonal psychotherapy (IPT) can bring about symptom remission in depressed elderly responding poorly to medication.


METHODS
Five cognitively intact patients aged over 60 and suffering from major depression were first treated for 6 weeks with a selective serotonin reuptake inhibitor compound. Owing to poor outcome, IPT was added to the treatment. IPT is a brief psychotherapy addressing the interpersonal problems linked to depression, and has been modified for use with elderly patients.


RESULTS
All patients achieved symptom remission after a cycle of psychotherapy lasting a minimum of 16 and a maximum of 20 weekly sessions.


CONCLUSIONS
The methodological limitations of this open study do not allow us to generalize from the positive outcomes. Further studies might confirm these initial observations and establish whether an equally satisfactory therapeutic response can be attained if medication is discontinued after the start of psychotherapy.
Scocco
Paolo
P
Department of Mental Health, ULSS 12, Venice, Italy. scoccopl@intercity.it
Frank
Ellen
E
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents