Treating late-life depression with interpersonal psychotherapy in the primary care sector.
BACKGROUND
Interpersonal psychotherapy (IPT) is an empirically-validated intervention for treating late-life depression.


OBJECTIVE
To determine the manner in which IPT is utilized by primary care physicians in relation to antidepressant medications.


METHODS
The authors reviewed treatment logs prepared by care managers during the first 12 months of a patient's participation in the PROSPECT clinical trial to determine initial and longitudinal treatment patterns utilized by physicians, and clinical outcomes associated with initial treatment assignment.


RESULTS
Primary care physicians in practices randomized to PROSPECT's intervention arm initially prescribed an antidepressant medication for 58% of eligible patients and referred only 11% of them to IPT. Over time, however, 27% of patients participated in IPT as monotherapy or augmentation therapy. Initial treatment assignment was not associated with depressive status at 4 and 12 months nor with suicidal ideation at 4, 8, and 12 months.


CONCLUSIONS
IPT is an effective treatment for late-life depression whose greater use by primary care physicians should be encouraged.
Schulberg
Herbert C
HC
Weill Medical College, Cornell University, White Plains, NY, USA. hcs2001@med.cornell.edu
Post
Edward P
EP
Raue
Patrick J
PJ
Have
Thomas Ten
TT
Miller
Mark
M
Bruce
Martha L
ML
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003156:Community Mental Health Services / Q000379:methods*; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011320:Primary Health Care / Q000379:methods; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome
D000928:Antidepressive Agents