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Efficacy of Interpersonal Psychotherapy as a Maintenance Treatment of Recurrent Depression: Contributing Factors

Efficacy of Interpersonal Psychotherapy as a Maintenance Treatment of Recurrent Depression:... Abstract • In earlier reports, we demonstrated that in patients with recurrent unipolar depression, survival time without a new episode of major depression following discontinuation of medication was significantly and positively related to continued interpersonal psychotherapy (IPT). To determine whether the prophylactic benefit of monthly sessions of IPT was a function of specific features of the intervention, we examined the contribution of the quality of IPT sessions to the length of the well interval in this 3-year maintenance trial. Therapy sessions were rated on specificity and purity of interpersonal interventions. Analysis of these ratings indicated that psychotherapy that was more specifically interpersonal was associated with significantly increased survival time. Patients whose therapy sessions were rated above the median on specificity of IPT had a median survival time of almost 2 years, while those below the median had a median survival time of less than 5 months. We concluded that when patient and therapist are able to maintain a high level of interpersonal focus, monthly sessions of IPT have substantial prophylactic benefit. References 1. Klerman GL, Weissman MM, Rounsaville BJ, Chevron ES. Interpersonal Psychotherapy of Depression . New York, NY: Basic Books Inc Publishers; 1984. 2. Luborsky L, McLellan AT, Woody GE, O'Brien CP, Auerbach A. Therapist success and its determinants . Arch Gen Psychiatry . 1985;42:602-611.Crossref 3. O'Malley SS, Foley SH, Rounsaville BJ, Watkins JT, Sotsky SM, Imber SD, Elkin I. Therapist competence and patient out-come in interpersonal psychotherapy of depression . J Consult Clin Psychol . 1988;56:496-501.Crossref 4. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 5. Crits-Cristoph P, Cooper A, Luborsky L. The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy . J Consult Clin Psychol . 1988;56:490-495.Crossref 6. Frank E, Kupfer DJ, Perel JM. Early recurrence in unipolar depression . Arch Gen Psychiatry . 1989;46:771-775.Crossref 7. Frank E, Kupfer DJ, Perel TM, Cornes CL, Jarrett DJ, Mallinger A, Thase ME, McEachran AB, Grochocinski VJ. Three-year outcomes for maintenance therapies in recurrent depression . Arch Gen Psychiatry . 1990;47:1093-1099.Crossref 8. Frank E. Interpersonal psychotherapy as a maintenance treatment for patients with recurrent depression . Psychotherapy . 1991;28:259-266.Crossref 9. De Rubeis RJ, Hollon SD, Evans MD, Bemis KM. Can psychotherapies for depression be discriminated? a systematic investigation of cognitive therapy and interpersonal therapy . J Consult Clin Psychol . 1982;50:744-756.Crossref 10. Elkin I, Shea MT, Watkins JT, Imber SD, Sotsky SM, Collins JF, Glass DR, Pilkonis PA, Leber WR, Docherty JP, Fiester SJ, Parloff MB. National Institute of Mental Health Treatment of Depression Collaborative Research Program: general effectiveness of treatments . Arch Gen Psychiatry . 1989;46:971-983.Crossref 11. Docherty JP. The individual psychotherapies: efficacy, syndrome-based treatments and the therapeutic alliance . In: Lazare A, ed. Outpatient Psychiatry Diagnosis and Treatment . Baltimore, Md: Williams & Wilkins; 1989:624-644. 12. Frank E, Anderson B, Stewart BD, Dancu C, Hughes C, West D. Efficacy of cognitive behavior therapy and systematic desensitization in the treatment of rape trauma . Behav Ther . 1988;19:403-420.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Efficacy of Interpersonal Psychotherapy as a Maintenance Treatment of Recurrent Depression: Contributing Factors

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1991.01810360017002
Publisher site
See Article on Publisher Site

Abstract

Abstract • In earlier reports, we demonstrated that in patients with recurrent unipolar depression, survival time without a new episode of major depression following discontinuation of medication was significantly and positively related to continued interpersonal psychotherapy (IPT). To determine whether the prophylactic benefit of monthly sessions of IPT was a function of specific features of the intervention, we examined the contribution of the quality of IPT sessions to the length of the well interval in this 3-year maintenance trial. Therapy sessions were rated on specificity and purity of interpersonal interventions. Analysis of these ratings indicated that psychotherapy that was more specifically interpersonal was associated with significantly increased survival time. Patients whose therapy sessions were rated above the median on specificity of IPT had a median survival time of almost 2 years, while those below the median had a median survival time of less than 5 months. We concluded that when patient and therapist are able to maintain a high level of interpersonal focus, monthly sessions of IPT have substantial prophylactic benefit. References 1. Klerman GL, Weissman MM, Rounsaville BJ, Chevron ES. Interpersonal Psychotherapy of Depression . New York, NY: Basic Books Inc Publishers; 1984. 2. Luborsky L, McLellan AT, Woody GE, O'Brien CP, Auerbach A. Therapist success and its determinants . Arch Gen Psychiatry . 1985;42:602-611.Crossref 3. O'Malley SS, Foley SH, Rounsaville BJ, Watkins JT, Sotsky SM, Imber SD, Elkin I. Therapist competence and patient out-come in interpersonal psychotherapy of depression . J Consult Clin Psychol . 1988;56:496-501.Crossref 4. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 5. Crits-Cristoph P, Cooper A, Luborsky L. The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy . J Consult Clin Psychol . 1988;56:490-495.Crossref 6. Frank E, Kupfer DJ, Perel JM. Early recurrence in unipolar depression . Arch Gen Psychiatry . 1989;46:771-775.Crossref 7. Frank E, Kupfer DJ, Perel TM, Cornes CL, Jarrett DJ, Mallinger A, Thase ME, McEachran AB, Grochocinski VJ. Three-year outcomes for maintenance therapies in recurrent depression . Arch Gen Psychiatry . 1990;47:1093-1099.Crossref 8. Frank E. Interpersonal psychotherapy as a maintenance treatment for patients with recurrent depression . Psychotherapy . 1991;28:259-266.Crossref 9. De Rubeis RJ, Hollon SD, Evans MD, Bemis KM. Can psychotherapies for depression be discriminated? a systematic investigation of cognitive therapy and interpersonal therapy . J Consult Clin Psychol . 1982;50:744-756.Crossref 10. Elkin I, Shea MT, Watkins JT, Imber SD, Sotsky SM, Collins JF, Glass DR, Pilkonis PA, Leber WR, Docherty JP, Fiester SJ, Parloff MB. National Institute of Mental Health Treatment of Depression Collaborative Research Program: general effectiveness of treatments . Arch Gen Psychiatry . 1989;46:971-983.Crossref 11. Docherty JP. The individual psychotherapies: efficacy, syndrome-based treatments and the therapeutic alliance . In: Lazare A, ed. Outpatient Psychiatry Diagnosis and Treatment . Baltimore, Md: Williams & Wilkins; 1989:624-644. 12. Frank E, Anderson B, Stewart BD, Dancu C, Hughes C, West D. Efficacy of cognitive behavior therapy and systematic desensitization in the treatment of rape trauma . Behav Ther . 1988;19:403-420.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Dec 1, 1991

References