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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

IPT is a brief form of psychotherapy, developed specifically for treatment of depression. It is based on the theoretical writings of Meyer and Sullivan and empirical research from epidemiology and clinical investigations. The efficacy of IPT for ambulatory depressive has been established in three controlled studies, two conducted by the investigators and one conducted by the National Institute of Mental Health.
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PMID:Interpersonal psychotherapy (IPT) and drugs in the treatment of depression. 354 19

Random regression models (RRMs) were used to investigate the role of initial severity in the outcome of 4 treatments (cognitive-behavior therapy [CBT], interpersonal psychotherapy [IPT], imipramine plus clinical management [IMI-CM], and placebo plus clinical management [PLA-CM]) for outpatients with major depressive disorder seen in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Initial severity of depression and impairment of functioning significantly predicted differential treatment effects. A larger number of differences than previously reported were found among the active treatments for the more severely ill patients; this was due, in large part, to the greater power of the present statistical analyses.
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PMID:Initial severity and differential treatment outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. 759 78

This paper presents a cost-utility analysis of three maintenance treatments for recurrent depression: interpersonal therapy (IPT-M), imipramine drug therapy (Drug), and a combination of the two. We base our analysis on the results of the University of Pittsburgh's Controlled Clinical Trial of Maintenance Therapies for Recurrent Depression. We construct a Markovian state-transition model to incorporate clinical effectiveness into cost and quality-of-life impacts; we assign empirical values to the parameters of this model; and we then use Monte Carlo analysis to compare the relative cost effectiveness of the different maintenance treatments. For the patients who met the eligibility standards for the study, Drug maintenance treatment is cost-effective in the strongest sense of the term compared to either a placebo group or IPT-M: it both improves expected lifetime health (measured in quality-adjusted life years, or QALYs) and reduces direct medical costs. This is true even when relatively severe side effects of the drug are considered. Compared to the placebo group, IPT-M and the combination of IPT-M and Drug each improve expected lifetime health, although in neither case are expected direct medical costs reduced. Still, the cost of the resulting health improvements, under $5000/QALY, are very reasonable. A similar conclusion holds comparing Drug and IPT-M to IPT-M alone. All of the above conclusions are quite robust to sensitivity analyses.
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PMID:Cost utility analysis of maintenance treatment for recurrent depression. 774 86

Among the forms of short-term psychotherapies for the treatment of depression, IPT (16 - 20 sessions) by Klerman u. Mitarb. is meanwhile one of the most well known and clinically practiced approaches. IPT has also been carefully controlled in a variety of studies proving efficacy. Interpersonal psychotherapy is based on the ideas of the interpersonal school of psychiatry. The hypothesis is that psychiatric illnesses and here depression develop in an interpersonal context. Life problems may contribute to onset and potentially chronicity of (current) depression and vice versa. By enhancing interpersonal functioning of the depressed patient IPT initiates the reduction of depressive symptomatology and helps solving of current life problems as dual goal of therapy.
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PMID:[Interpersonal psychotherapy (IPT) of depression: an overview of the psychiatric historical background and clinical practice of IPT]. 1188 Sep 48

Rates of recurrent depression peak among women in their childbearing years, yet a large number of these women are not treated or do not seek maintenance treatment between episodes. Barriers to treatment include time constraints, demands of child care, and finances. A method for improving access to treatment of depression may be delivery of psychotherapy over the telephone. A 12-week pilot controlled clinical trial with random assignment was conducted to test the feasibility and efficacy of Interpersonal Psychotherapy delivered over the telephone (IPT-T) for depression in women (N=15 IPT-T and N=15 no treatment) with a life-time history of recurrent depression and low rates of previous treatment. Patients were interviewed at baseline and at 12 weeks by a blind and independent clinical evaluator to assess their symptom level and social functioning. IPT-T as compared to no treatment was significantly better in lowering symptoms of depression as measured by the Hamilton Rating Scale for Depression (p<.02), improving global functioning (GAS) (p<.02), and improving work and social functioning (p<.03-.05, respectively). These preliminary findings support the feasibility and helpfulness of IPT-T in preventing an increase in depressive symptoms among women with recurrent depression but current mild to moderately levels of depression.
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PMID:Interpersonal psychotherapy delivered over the telephone to recurrent depressives. A pilot study. 1241 35

This study was aimed to evaluate the role of psychotherapy in psychiatric in-patient care at the example of the Bezirksklinikum Regensburg (BKR) (Community Clinic in Regensburg, Germany). Based on a sample of 6,719 patients suffering from F2-F6 ICD-10 diagnoses, the data of the psychiatric basic documentation (BADO) from January 1995 until April 1999 was retrospectively analysed regarding type and frequency of psychotherapy, influencing factors on indication, and effects of psychotherapy on treatment success. In 33% of cases, specific psychotherapy was in use. A client-centered therapy was carried out in 20% of patients. Other techniques of psychotherapy such as behaviour therapy, cognitive therapy, IPT for schizophrenics, or psychodynamic psychotherapy were applied to 2-6% of patients. Inpatients with eating disorders, personality disorders, neurotic disorders, somatization disorders, and depression were more likely to receive a specific psychotherapy. A significantly positive effect on treatment success was only documented in affective disorders, whereas a significantly negative influence was found in personality disorders.
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PMID:[Psychotherapy in a psychiatric hospital]. 1243 50

There is evidence that abnormalities in the dopaminergic system involving the dopamine transporter (DAT) are involved in the pathophysiology of Tourette's disorder (TD) from previous studies using [(123)I]2beta-carbomethoxy-3-(4-iodophenyl)tropane ([(123)I]beta-CIT) and single photon emission tomography (SPECT). However, because those studies were performed in medicated adult patients with TD, we decided to compare DAT densities in nine drug-naive children with TD and eight normal children. The children with TD did not suffer from associated psychiatric problems such as obsessive-compulsive symptoms, attention deficit hyperactivity disorder, anxiety, depression and developmental difficulties. We performed brain SPECT 2 h after the intravenous administration of I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane ([(123)I]IPT) and carried out both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of the specific/non-specific DAT binding ratio in the basal ganglia. We then investigated the correlation between the severity of tics in children with TD assessed with the Yale Global Tic Severity Scale (YGTSS) and the specific/non-specific DAT binding ratio of the basal ganglia. Drug-naive children with TD showed a significantly increased specific/non-specific DAT binding ratio in the basal ganglia compared with normal children that did not correlate significantly with the severity of tics. Our results with drug-naive children with TD between the ages of 6 and 12 may help to clarify previous findings concerning DAT binding in adult patients with TD and suggest that DAT densities may be associated directly with the pathophysiology of TD, regardless of disease progress or drug effect.
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PMID:Dopamine transporter density of the basal ganglia assessed with [123I]IPT SPECT in drug-naive children with Tourette's disorder. 1497 71

Major depression affects one out of five women during her lifetime. Depressed mothers with psychiatrically ill children represent an especially vulnerable population. Challenged by the demands of caring for ill children, these mothers often put their own needs last; consequently, their depressions remain untreated. This population is especially difficult to engage in treatment. We have developed a nine-session intervention, an engagement session followed by eight sessions of brief interpersonal psychotherapy designed to increase maternal participation in their own psychotherapy, resolve symptoms of maternal depression, and enhance relationships (IPT-MOMS). This open-label trial assesses the feasibility and acceptability of providing this treatment to depressed mothers. Thirteen mothers meeting DSM-IV criteria for major depression were recruited from a pediatric mental health clinic where their school-age children were receiving psychiatric treatment. Subjects (mothers) were treated openly with IPT-MOMS. Eighty-five percent (11/13) completed the study. Subjects were evaluated with the Hamilton Rating Scale for Depression, and completed self-report measures of quality of life and functioning at three time points: baseline, after treatment completion, and 6-months posttreatment. A signed rank test was used to compare measurement changes between assessment time points. Subjects showed significant improvement from baseline to posttreatment on measures of maternal symptoms and functioning. These gains were maintained at 6-month follow-up. Therapy was well tolerated and accepted by depressed mothers, who are typically difficult to engage in treatment. A high proportion of subjects completed treatment and experienced improvements in functioning. Future randomized clinical trials are needed to establish the efficacy of this approach.
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PMID:An open-label trial of enhanced brief interpersonal psychotherapy in depressed mothers whose children are receiving psychiatric treatment. 1684 41

Contrary to earlier assumptions, the current consensus is that depression constitutes an important issue in the mental health of children and adolescents. Thus, effective therapy options for depressive children and adolescents are needed. Randomized, controlled intervention studies are reviewed: 24 studies on pharmacological interventions, 11 studies on psychological interventions, and two on combination therapy. For approximately half of the intervention methods (pharmacotherapy: 3/8; psychotherapy: 2/5) no randomized, controlled studies carried out. Furthermore, only some SSRI (fluoxetin, citalopram and sertralin) yielded positive results with regard to depressive symptoms. Beyond these results, fluoxetin is the sole pharmacological treatment during which suicidality does not increase as compared to results for a placebo control group (Hammad et al., 2006; Whittington et al., 2004). Earlier studies of CBT, IPT, and family therapy reported predominantly positive effects. Nevertheless, initial results for combination therapies (SSRI & CBT) indicate an advantage of this therapy approach over mono-therapies. Empirical data are described, followed by a discussion of the strengths and limitations of the earlier studies.
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PMID:[Effects of pharmaco- and psychotherapeutic interventions in depression among children and adolescents]. 1692 67

Many aspects of the treatment for adolescent depression are still uncertain. However, our body of knowledge continues to accumulate, and our approaches continue to be refined. When we remember that 40 years ago the field was still arguing about the existence of depression in youth, it is clear that significant progress has been made. Recent controversies have provided another opportunity to step back and re-evaluate. Given the chronicity, morbidity, and mortality associated with adolescent depression, the risks of doing nothing are too great. Evidence-based research has provided us with some direction during this unsettling time. After careful reviews, the major professional organizations representing pediatric medicine and psychiatry all support the continued use of SSRI antidepressant medications but emphasize close monitoring. The debates also have heightened interest in effective psychotherapy approaches, particularly CBT and IPT. Given the risk for suicidality in depressed adolescents, assessment and management of safety concerns remain critical, regardless of medication usage. Above all, it is most important that we remain hopeful about our ability to guide adolescents and families through the struggles with depression toward recovery.
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PMID:Adolescent depression: challenges and opportunities: a review and current recommendations for clinical practice. 1708 65


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