Treating late-life depression with interpersonal psychotherapy in the primary care sector.

Overview

BACKGROUND: Interpersonal psychotherapy (IPT) is an empirically-validated intervention for treating late-life depression. OBJECTIVE: To determine the manner in which IPT is utilized by primary care physicians in relation to antidepressant medications. METHODS: The authors reviewed treatment logs prepared by care managers during the first 12 months of a patient's participation in the PROSPECT clinical trial to determine initial and longitudinal treatment patterns utilized by physicians, and clinical outcomes associated with initial treatment assignment. RESULTS: Primary care physicians in practices randomized to PROSPECT's intervention arm initially prescribed an antidepressant medication for 58% of eligible patients and referred only 11% of them to IPT. Over time, however, 27% of patients participated in IPT as monotherapy or augmentation therapy. Initial treatment assignment was not associated with depressive status at 4 and 12 months nor with suicidal ideation at 4, 8, and 12 months. CONCLUSION: IPT is an effective treatment for late-life depression whose greater use by primary care physicians should be encouraged.