A controlled evaluation of monthly maintenance interpersonal psychotherapy in late-life depression with varying levels of cognitive function.
OBJECTIVE
To evaluate the effect of maintenance Interpersonal Psychotherapy (IPT) on recurrence rates and time to recurrence of major depression in elderly patients with varying levels of cognitive function.


METHODS
Two-year maintenance study of monthly maintenance IPT vs supportive clinical management (CM) in remitted depressed elderly who were participants in a previously reported placebo-controlled study of maintenance paroxetine and IPT (Reynolds et al., 2006). We used Cox regression analysis to test interactions between cognitive status (Dementia Rating Scale score) and treatment (IPT, CM) with respect to recurrence of major depression.


RESULTS
We observed a significant interaction between cognitive status and treatment: lower cognitive performance was associated with longer time to recurrence in IPT than in CM (58 weeks vs 17 weeks) (HR = 1.41 [95% CI = 1.04, 1.91], p = 0.03). Subjects with average cognitive performance showed no effect of maintenance IPT vs CM on time to recurrence (38 vs 32 weeks, respectively).


CONCLUSIONS
Monthly maintenance IPT confers protection against recurrence of major depression in elders with lower cognitive functioning.
Carreira
Kristen
K
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Miller
Mark D
MD
Frank
Ellen
E
Houck
Patricia R
PR
Morse
Jennifer Q
JQ
Dew
Mary Amanda
MA
Butters'
Meryl A
MA
Reynolds
Charles F
CF
D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003071:Cognition; D003866:Depressive Disorder / Q000188:drug therapy / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D017374:Paroxetine / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D055502:Secondary Prevention; D013997:Time Factors
D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine