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Using Interpersonal Psychotherapy (IPT) in a Combined Psychotherapy/ Medication Research Protocol With Depressed Elders: A Descriptive Report With Case Vignettes

Received September 3, 1996; revised April 22, 1997; accepted April 29, 1997. From the Mental Health Clinical Research Center for the Study of Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Address correspondence to Dr. Miller, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, 7th Floor Bellefield Towers, Pittsburgh, PA 15213.

One hundred eighty subjects at least 60 years of age with recurrent unipolar major depression were recruited to participate in a depression treatment protocol. All patients received drug therapy with nortriptyline (NT) and interpersonal psychotherapy (IPT) with an experienced clinician. Acutely, 81% of subjects showed a full response to combined treatment. In the initial 127 subjects, the most common problem areas in therapy were role transition (41%), interpersonal disputes (34.5%), and grief (23%). Case vignettes are presented and discussed. The combination of IPT and NT showed a powerful antidepressant effect. IPT was readily adaptable to the needs of depressed elders.