The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review
1 Caphri, School of Public Health and Primary Care; Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands
2 College of Pharmacy and Nutrition, University of Saskatchewan, Saskoon, Canada
3 Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
4 Caphri, School of Public Health and Primary Care; Department of Health Services Research, Maastricht University, Maastricht, the Netherlands
BMC Psychiatry 2013, 13:22 doi:10.1186/1471-244X-13-22Published: 11 January 2013
This systematic review describes a comparison between several standard treatments for major depressive disorder (MDD) in adult outpatients, with a focus on interpersonal psychotherapy (IPT).
Systematic searches of PubMed and PsycINFO studies between January 1970 and August 2012 were performed to identify (C-)RCTs, in which MDD was a primary diagnosis in adult outpatients receiving individual IPT as a monotherapy compared to other forms of psychotherapy and/or pharmacotherapy.
1233 patients were included in eight eligible studies, out of which 854 completed treatment in outpatient facilities. IPT combined with nefazodone improved depressive symptoms significantly better than sole nefazodone, while undefined pharmacotherapy combined with clinical management improved symptoms better than sole IPT. IPT or imipramine hydrochloride with clinical management showed a better outcome than placebo with clinical management. Depressive symptoms were reduced more in CBASP (cognitive behavioral analysis system of psychotherapy) patients in comparison with IPT patients, while IPT reduced symptoms better than usual care and wait list condition.
The differences between treatment effects are very small and often they are not significant. Psychotherapeutic treatments such as IPT and CBT, and/or pharmacotherapy are recommended as first-line treatments for depressed adult outpatients, without favoring one of them, although the individual preferences of patients should be taken into consideration in choosing a treatment.