title: Is interpersonal counselling (IPC) sufficient treatment for depression in primary care patients? A pilot study comparing IPC and interpersonal psychotherapy (IPT).
abstract: BACKGROUND
  Psychotherapeutic treatment is underused in primary care, where even short-term psychotherapy can be perceived as too lengthy and labour-intensive. We tested here for the first time the preliminary efficacy of seven sessions of interpersonal counselling (IPC) by comparison with sixteen sessions of interpersonal psychotherapy (IPT) in regular clinical settings.
  
  
  METHODS
  Patients seeking treatment for the first time who met the DSM-IV criteria for major depressive disorder (MDD, mild/moderate) were randomized to either IPC (n=20) or IPT (n=20). The efficacy of the treatments was assessed using the 34-item Clinical Outcomes in Routine Evaluation (CORE-OM) scale and the Beck Depression Inventory (BDI) scale.
  
  
  RESULTS
  90% of the patients completed all the treatment sessions. IPC delivered by psychiatric nurses in primary care proved equally as effective as IPT delivered by psychotherapists/psychologists in secondary care. The pre-treatment to 12-month follow-up within-group effect sizes were large: 1.52 (CORE-OM) and 1.41 (BDI) in the IPC group and 1.58 (CORE-OM) and 1.40 (BDI) in the IPT group. At the 12-month follow-up 59% of the patients in the IPC group and 63% in the IPT group were classified as recovered on the CORE-OM scale, with corresponding remission rates of 61% for both groups on the BDI scale.
  
  
  CONCLUSIONS
  The small sample size limited the power to detect differences between the groups and the naturalistic settings may have confounded the results.
  
  
  CONCLUSIONS
  This clinical trial suggests that IPC is an appropriate and even sufficient first-phase intervention for handling previously untreated mild to moderate depression in primary health care.
authors.affiliation: Department of Psychology, University of Jyväskylä, Finland. Electronic address: jarmo.kontunen@sicom.fi.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Kontunen
authors.affiliation: Institute of Health Sciences, University of Oulu, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Timonen
authors.affiliation: Department of Psychology, University of Jyväskylä, Finland.
authors.forename: Joona
authors.initials: J
authors.lastname: Muotka
authors.affiliation: Department of Psychiatry, Savonlinna Central Hospital, and Institute of Health Sciences, University of Oulu, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Liukkonen
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief / Q000379:methods*; D016896:Treatment Outcome
keywords: CORE-OM; Depression; IPC; Interpersonal counselling; Interpersonal therapy; Primary care