A systematic review of research findings on the efficacy of interpersonal therapy for depressive disorders.
OBJECTIVE
Interpersonal psychotherapy (IPT) is a time-limited psychotherapy for major depression. The aim of this study is to summarize findings from controlled trials of the efficacy of IPT in the treatment of depressive spectrum disorders (DSD) using a meta-analytic approach.


METHODS
Studies of randomized clinical trials of IPT efficacy were located by searching all available data bases from 1974 to 2002. The searches employed the following MeSH categories: Depression/ Depressive Disorder; Interpersonal therapy; Outcome/Adverse Effects/Efficacy; in the identified studies. The efficacy outcomes were: remission; clinical improvement; the difference in depressive symptoms between the two arms of the trial at endpoint, and no recurrence. Drop out rates were used as an index of treatment acceptability.


RESULTS
Thirteen studies fulfilled inclusion criteria and four meta-analyses were performed. IPT was superior in efficacy to placebo in nine studies (Weight Mean Difference (WMD) - 3.57 [-5.9, -1.16]). The combination of IPT and medication did not show an adjunctive effect compared to medication alone for acute treatment (RR 0.78 [0.30, 2.04]), for maintenance treatment (RR 1.01 [0.81, 1.25]), or for prophylactic treatment (RR 0.70 [0.30, 1.65]). IPT was significantly better than CBT (WMD -2.16 [-4.16,-0.15]).


CONCLUSIONS
The efficacy of IPT proved to be superior to placebo, similar to medication and did not increase when combined with medication. Overall, IPT was more efficacious than CBT. Current evidence indicates that IPT is an efficacious psychotherapy for DSD and may be superior to some other manualized psychotherapies.
de Mello
Marcelo Feijo
MF
Department of Psychiatry, Federal University of São Paulo, São Paulo SP 04026-010, Brazil. mf-mello@uol.com.br
de Jesus Mari
Jair
J
Bacaltchuk
Josue
J
Verdeli
Helen
H
Neugebauer
Richard
R
D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D007398:Interpersonal Relations; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy
D000928:Antidepressive Agents