Interpersonal psychotherapy for elderly patients in primary care.
OBJECTIVE
Interpersonal psychotherapy (IPT) is recommended in most depression treatment guidelines, but little is known about its effectiveness in real-life practice. This study investigates whether IPT, delivered by mental health workers to elderly patients with major depressive disorder, is more effective than usual general practitioners' care (CAU).


METHODS
A pragmatic randomized, controlled trial was conducted in which 143 patients were allocated to IPT (10 sessions) or to CAU. PRIMary care Evaluation of Mental Disorders (PRIME-MD) and Montgomery Asberg Depression Rating Scale (MADRS) assessments were used as primary outcomes.


RESULTS
IPT was significantly more effective in reducing the percentage of patients with a diagnosis of depression (PRIME-MD), but not in inducing remission (MADRS <10). Among treatment completers, IPT was superior in improving social and overall mental functioning. A post hoc analysis revealed that IPT was superior to CAU in moderately to severely depressed patients, but not significantly so in mildly depressed patients.


CONCLUSIONS
IPT was more effective than CAU for elderly patients with moderate to severe major depressive disorder in general practice. Future research should focus on determinants of treatment outcome.
van Schaik
Anneke
A
Department of Psychiatry, Department of General Practice, Institute for Research in Extramural Medicine (EMGO), VU University Medical Center, Amsterdam, The Netherlands. a.van.schaik@ggzba.nl
van Marwijk
Harm
H
Adèr
Herman
H
van Dyck
Richard
R
de Haan
Marten
M
Penninx
Brenda
B
van der Kooij
Koen
K
van Hout
Hein
H
Beekman
Aartjan
A
D000368:Aged; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012720:Severity of Illness Index