Comparative outcomes among the problem areas of interpersonal psychotherapy for depression
Identifieur interne : 002E36 ( Istex/Corpus ); précédent : 002E35; suivant : 002E37Comparative outcomes among the problem areas of interpersonal psychotherapy for depression
Auteurs : J. C. Levenson ; E. Frank ; Y. Cheng ; P. Rucci ; C. A. Janney ; P. Houck ; R. N. Forgione ; H. A. Swartz ; J. M. Cyranowski ; A. FagioliniSource :
- Depression and Anxiety [ 1091-4269 ] ; 2010-05.
English descriptors
- KwdEn :
- Acute phase, Adjunctive pharmacotherapy, Baseline score, Basic books, Bristol myers squibb, Careful medication management, Clinical characteristics, Clinical interview, Clinical variables, Combination therapy, Conventional levels, Depressed patients, Depression onset, Depressive, Education level, Equal success, First depressive episode, Forest research institute, Grief deficits disputes, Grief group, Guilford press, Interpersonal, Interpersonal deficits, Interpersonal deficits group, Interpersonal problems, Interpersonal psychotherapy, Life event, Maintenance therapies, Median time, Medication, More personality pathology, National institute, Other groups, Other party, Oxford university press, Patient characteristics, Personality disorder diagnosis, Personality disorders, Personality pathology, Pharmacotherapy, Problem area, Problem area assignment, Problem area group, Problem area groups, Problem areas, Proportional hazard model, Psychiatry, Psychotherapy, Rank test, Recurrent depression, Reference group, Relative efficacy, Remission, Research article, Research program, Role disputes, Role disputes group, Role transitions, Role transitions group, Role transitions groups, Secondary focus, Secondary problem area, Shorter time, Significant difference, Significant differences, Statistical significance, Study participants, Study procedures, Survival analyses, Survival times, Treatment focus, Treatment outcome, Triage points.
- Teeft :
- Acute phase, Adjunctive pharmacotherapy, Baseline score, Basic books, Bristol myers squibb, Careful medication management, Clinical characteristics, Clinical interview, Clinical variables, Combination therapy, Conventional levels, Depressed patients, Depression onset, Depressive, Education level, Equal success, First depressive episode, Forest research institute, Grief deficits disputes, Grief group, Guilford press, Interpersonal, Interpersonal deficits, Interpersonal deficits group, Interpersonal problems, Interpersonal psychotherapy, Life event, Maintenance therapies, Median time, Medication, More personality pathology, National institute, Other groups, Other party, Oxford university press, Patient characteristics, Personality disorder diagnosis, Personality disorders, Personality pathology, Pharmacotherapy, Problem area, Problem area assignment, Problem area group, Problem area groups, Problem areas, Proportional hazard model, Psychiatry, Psychotherapy, Rank test, Recurrent depression, Reference group, Relative efficacy, Remission, Research article, Research program, Role disputes, Role disputes group, Role transitions, Role transitions group, Role transitions groups, Secondary focus, Secondary problem area, Shorter time, Significant difference, Significant differences, Statistical significance, Study participants, Study procedures, Survival analyses, Survival times, Treatment focus, Treatment outcome, Triage points.
Abstract
Background: Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. Methods: Patients meeting DSM‐IV criteria for an episode of major depressive disorder (n=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17‐item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM‐IV Personality Disorders. Results: Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. Conclusion: With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.
Url:
DOI: 10.1002/da.20661
Links to Exploration step
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<front><div type="abstract" xml:lang="en">Background: Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. Methods: Patients meeting DSM‐IV criteria for an episode of major depressive disorder (n=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17‐item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM‐IV Personality Disorders. Results: Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. Conclusion: With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.</div>
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<abstract>Background: Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. Methods: Patients meeting DSM‐IV criteria for an episode of major depressive disorder (n=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17‐item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM‐IV Personality Disorders. Results: Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. Conclusion: With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.</abstract>
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<p><hi rend="italic">Background:</hi>
Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. <hi rend="italic">Methods:</hi>
Patients meeting DSM‐IV criteria for an episode of major depressive disorder (<hi rend="italic"><hi rend="bold">n</hi>
</hi>
=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17‐item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM‐IV Personality Disorders. <hi rend="italic">Results:</hi>
Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. <hi rend="italic">Conclusion:</hi>
With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.</p>
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<abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title>
<p><i>Background:</i>
Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. <i>Methods:</i>
Patients meeting DSM‐IV criteria for an episode of major depressive disorder (<i><b>n</b>
</i>
=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17‐item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM‐IV Personality Disorders. <i>Results:</i>
Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. <i>Conclusion:</i>
With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.</p>
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<noteGroup><note xml:id="fn1"><label>*</label>
<p><i>The authors disclose the following financial relationships within the past 3 years</i>
: Dr. Fagiolini is a speaker and/or a consultant for Boeringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Jannssen, Lundbeck, Novartis, Pfizer, and Takeda. Dr. Rucci has received support from Forest Research Institute and Fondazione IDEA. Dr. Forgione has prepared slides for Bristol‐Myers Squibb personnel training. Dr. Frank has received support from Servier International, Guilford Press, Forest Research Institute, and Lundbeck. Dr. Cyranowski has received support from the National Institute of Health and the Pittsburgh Foundation. She has no conflict of interest to report with respect to this study. Dr. Swartz has served as a speaker for Astra Zeneca, Eli Lilly, and Bristol Myers Squibb, has served on the advisory boards of Novartis and Bristol Myers Squibb, has received an honorarium from Servier for book chapter, and has received grant support from Bristol Myers Squibb. Ms. Janney served as Pfizer legal consultant while employed at Parke‐Davis Pharmaceutical Co. Other financial support has come from the University of Pittsburgh. Ms. Levenson anticipates royalties from American Psychological Association Books. Dr. Cheng and Ms. Houck have no conflicts to report.</p>
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<mods version="3.6"><titleInfo lang="en"><title>Comparative outcomes among the problem areas of interpersonal psychotherapy for depression</title>
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<titleInfo type="abbreviated" lang="en"><title>Research Article: Problem Areas of Interpersonal Psychotherapy</title>
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<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Comparative outcomes among the problem areas of interpersonal psychotherapy for depression</title>
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<name type="personal"><namePart type="given">J.C.</namePart>
<namePart type="family">Levenson</namePart>
<namePart type="termsOfAddress">M.S.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
<affiliation>Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania</affiliation>
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<name type="personal"><namePart type="given">E.</namePart>
<namePart type="family">Frank</namePart>
<namePart type="termsOfAddress">Ph.D.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
<affiliation>Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania</affiliation>
<affiliation>E-mail: franke@upmc.edu</affiliation>
<affiliation>Correspondence address: Department of Psychiatry, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213</affiliation>
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<namePart type="family">Cheng</namePart>
<namePart type="termsOfAddress">Ph.D.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
<affiliation>Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania</affiliation>
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<name type="personal"><namePart type="given">P.</namePart>
<namePart type="family">Rucci</namePart>
<namePart type="termsOfAddress">Ph.D.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
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<name type="personal"><namePart type="given">C.A.</namePart>
<namePart type="family">Janney</namePart>
<namePart type="termsOfAddress">M.S.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
<affiliation>Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">P.</namePart>
<namePart type="family">Houck</namePart>
<namePart type="termsOfAddress">M.S.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
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<name type="personal"><namePart type="given">R.N.</namePart>
<namePart type="family">Forgione</namePart>
<namePart type="termsOfAddress">D.Econ.</namePart>
<affiliation>Department of Psychiatry, University of Siena, Siena, Italy</affiliation>
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</role>
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<name type="personal"><namePart type="given">H.A.</namePart>
<namePart type="family">Swartz</namePart>
<namePart type="termsOfAddress">M.D.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
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</role>
</name>
<name type="personal"><namePart type="given">J.M.</namePart>
<namePart type="family">Cyranowski</namePart>
<namePart type="termsOfAddress">Ph.D.</namePart>
<affiliation>Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">A.</namePart>
<namePart type="family">Fagiolini</namePart>
<namePart type="termsOfAddress">M.D.</namePart>
<affiliation>Department of Neuroscience, University of Siena School of Medicine, Siena, Italy</affiliation>
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<abstract lang="en">Background: Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. Methods: Patients meeting DSM‐IV criteria for an episode of major depressive disorder (n=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17‐item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM‐IV Personality Disorders. Results: Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. Conclusion: With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.</abstract>
<note type="content">*The authors disclose the following financial relationships within the past 3 years: Dr. Fagiolini is a speaker and/or a consultant for Boeringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Jannssen, Lundbeck, Novartis, Pfizer, and Takeda. Dr. Rucci has received support from Forest Research Institute and Fondazione IDEA. Dr. Forgione has prepared slides for Bristol‐Myers Squibb personnel training. Dr. Frank has received support from Servier International, Guilford Press, Forest Research Institute, and Lundbeck. Dr. Cyranowski has received support from the National Institute of Health and the Pittsburgh Foundation. She has no conflict of interest to report with respect to this study. Dr. Swartz has served as a speaker for Astra Zeneca, Eli Lilly, and Bristol Myers Squibb, has served on the advisory boards of Novartis and Bristol Myers Squibb, has received an honorarium from Servier for book chapter, and has received grant support from Bristol Myers Squibb. Ms. Janney served as Pfizer legal consultant while employed at Parke‐Davis Pharmaceutical Co. Other financial support has come from the University of Pittsburgh. Ms. Levenson anticipates royalties from American Psychological Association Books. Dr. Cheng and Ms. Houck have no conflicts to report.</note>
<subject lang="en"><genre>keywords</genre>
<topic>mood disorders</topic>
<topic>treatment outcome</topic>
<topic>personality disorders</topic>
<topic>specificity</topic>
<topic>pharmacotherapy</topic>
</subject>
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<identifier type="ISSN">1091-4269</identifier>
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