An open-label trial of interpersonal psychotherapy in depressed patients with coronary disease.
High rates of depression have been reported in patients with coronary artery disease, and depression has been repeatedly shown to adversely affect cardiac morbidity and mortality. Despite these findings, little work has been devoted to evaluating effective antidepressant treatments for this subpopulation. This open-label trial assessed the efficacy and acceptability of interpersonal psychotherapy in depressed patients with stable coronary artery disease. Seventeen patients with coronary artery disease who met DSM-IV criteria for major depression received 12 weekly sessions of interpersonal psychotherapy. Outcome was assessed with the 17-item Hamilton Depression Rating Scale and the Beck Depression Inventory II. Ten patients received medication during the trial, and seven patients received interpersonal psychotherapy alone. The patients showed a significant reduction in scores on both the Hamilton depression scale and the Beck Depression Inventory II from baseline, with 53% of the patients meeting criteria for remission, as defined by scores of < or =7 and < or =14 on the Hamilton depression scale and the Beck Depression Inventory II, respectively. Medicated and unmedicated patients responded similarly to interpersonal psychotherapy. These data provide support for the potential use of interpersonal psychotherapy in depressed patients with coronary artery disease. The therapy was well tolerated and accepted by patients, with a high proportion achieving remission. Future randomized clinical trials are needed to establish its efficacy.
Koszycki
Diana
D
University of Ottawa Heart Institute and the Institute of Mental Health Research, Royal Ottawa Hospital, Ont. Canada. dkoszyck@rohcg.on.ca
Lafontaine
Sylvain
S
Frasure-Smith
Nancy
N
Swenson
Robert
R
Lespérance
François
F
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000150:complications* / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D012074:Remission Induction; D016896:Treatment Outcome