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Am J Geriatr Psychiatry 14:777-786, September 2006
© 2006 American Association for Geriatric Psychiatry
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Article

Interpersonal Psychotherapy for Elderly Patients in Primary Care

Anneke van Schaik, M.D., Harm van Marwijk, M.D., Ph.D., Herman Adèr, Ph.D., Richard van Dyck, M.D., Ph.D., Marten de Haan, M.D., Ph.D., Brenda Penninx, Ph.D., Koen van der Kooij, M.Sc., Hein van Hout, Ph.D., and Aartjan Beekman, M.D., Ph.D.

From the Department of Psychiatry, Department of General Practice, and Department of Clinical Epidemiology & Biostatistics, Institute for Research in Extramural Medicine (EMGO), VU University Medical Center, Amsterdam.

Objective: Interpersonal psychotherapy (IPT) is recommended in most depression treatment guidelines, but little is known about its effectiveness in real-life practice. This study investigates whether IPT, delivered by mental health workers to elderly patients with major depressive disorder, is more effective than usual general practitioners’ care (CAU).

Methods: A pragmatic randomized, controlled trial was conducted in which 143 patients were allocated to IPT (10 sessions) or to CAU. PRIMary care Evaluation of Mental Disorders (PRIME-MD) and Montgomery Åsberg Depression Rating Scale (MADRS) assessments were used as primary outcomes.

Results: IPT was significantly more effective in reducing the percentage of patients with a diagnosis of depression (PRIME-MD), but not in inducing remission (MADRS <10). Among treatment completers, IPT was superior in improving social and overall mental functioning. A post hoc analysis revealed that IPT was superior to CAU in moderately to severely depressed patients, but not significantly so in mildly depressed patients.

Conclusions: IPT was more effective than CAU for elderly patients with moderate to severe major depressive disorder in general practice. Future research should focus on determinants of treatment outcome.

Key Words: Major depressive disorder • primary care • elderly • interpersonal psychotherapy (IPT)






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