Randomised controlled trial of interpersonal psychotherapy and cognitive-behavioural therapy for depression.
BACKGROUND
Interpersonal psychotherapy and cognitive-behavioural therapy (CBT) are established as effective treatments for major depression. Controversy remains regarding their effectiveness for severe and melancholic depression.


OBJECTIVE
To compare the efficacy of interpersonal psychotherapy and CBT in people receiving out-patient treatment for depression and to explore response in severe depression (Montgomery-Asberg Depression Rating Scale (MADRS) score above 30), and in melancholic depression.


METHODS
Randomised clinical trial of 177 patients with a principal Axis I diagnosis of major depressive disorder receiving 16 weeks of therapy comprising 8-19 sessions. Primary outcome was improvement in MADRS score from baseline to end of treatment.


RESULTS
There was no difference between the two psychotherapies in the sample as a whole, but CBT was more effective than interpersonal psychotherapy in severe depression, and the response was comparable with that for mild and moder-ate depression. Melancholia did not predict poor response to either psychotherapy.


CONCLUSIONS
Both therapies are equally effective for depression but CBT may be preferred in severe depression.
Luty
Suzanne E
SE
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, PO Box 4345, Christchurch, New Zealand. sue.luty@chmeds.ac.nz
Carter
Janet D
JD
McKenzie
Janice M
JM
Rae
Alma M
AM
Frampton
Christopher M A
CM
Mulder
Roger T
RT
Joyce
Peter R
PR
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome