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Monthly Maintenance Interpersonal Psychotherapy Sufficient to Prevent Relapse of Depression in Many Women, Says Pitt Study


Most women with recurrent depression may be able to prevent subsequent depressive episodes with monthly maintenance interpersonal psychotherapy (IPT), say researchers from the University of Pittsburgh School of Medicine in a study published in the May issue of the American Journal of Psychiatry.

Researchers found that once-per-month maintenance IPT, a form of therapy which focuses on relationships and interpersonal events that tend to trigger depression, was effective in preventing recurrence of depression in women who achieved remission through IPT alone. In fact, women who received prophylactic IPT once a month were no more likely to have a recurrence of their depression than those who received IPT two or four times a month. Maintenance IPT was found to be less effective for preventing recurrence in women who achieved remission through combination IPT and antidepressant therapy.

“Studies have shown that when a person recovers from depression by using medication, the best way for them to stay well is to continue on the same dosage of medication. However, many people, especially women of childbearing age or those taking medications for other conditions, may not feel comfortable taking antidepressants for long periods of time,” said Ellen Frank, Ph.D., professor of psychiatry, University of Pittsburgh School of Medicine. “We found that interpersonal psychotherapy is a valid alternative to help women with recurrent depression remain symptom-free, especially women who were able to recover from a depressive episode using therapy alone.”

The Pittsburgh study looked at 99 women whose depressive episodes remitted after outpatient treatment with IPT alone and 32 women who achieved remission with outpatient IPT and antidepressant treatment. The women were randomly assigned to receive maintenance IPT focused on preventing future depressive episodes at intervals of once per week, twice per month or once per month over the course of two years, or until they had a subsequent depressive episode.

Of those who initially remitted with IPT alone, 74 completed the two-year maintenance phase. Only 19, or 26 percent, had a recurrence of depression. Of those who remitted with IPT and antidepressant therapy, 26 completed the maintenance phase. Half had a recurrence of depression. In both groups there was no significant difference in recurrence rates between those who received maintenance IPT weekly, bi-monthly or monthly.

“Our study indicates, as many prior studies have, that not every person’s depression is the same, nor should each person be treated the same way,” said Dr. Frank. “Some people respond best to therapy, others to medication and others to a combination of the two. It’s important that clinicians evaluate their patients carefully to determine the best treatment for each individual.”

The study was funded by the National Institute of Mental Health.

Other authors include David J. Kupfer, M.D., Daniel J. Buysse, M.D., Holly A. Swartz, M.D., Paul A. Pilkonis, Ph.D., Patricia R. Houck, M.S.H., Paola Rucci, Ph.D., Danielle M. Novick, M.S., Victoria J. Grochocinski, Ph.D., and Deborah M. Stapf, B.S., all of the University of Pittsburgh.


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