Although several forms of treatment have shown promise in ameliorating the long-term course of recurrent depression, a better understanding of the preventative capacity of psychotherapy seems particularly critical for women given the many psychosocial vulnerability factors for depression observed in women and the adverse implications of antidepressant maintenance treatment throughout the childbearing years. Our recently completed study of Maintenance Therapies in Recurrent Depression points to the possible utility of interpersonal psychotherapy as a maintenance strategy, particularly in women.
The specific aim of this proposal is to expand our knowledge regarding the prophylactic capacity of maintenance interpersonal psychotherapy (IPT-M) in women. In order to determine whether a higher """"""""dose"""""""" of IPT-M than was employed in our recent trial can further extend survival time and prevent recurrence, depressed women in at least their second discrete episode of unipolar depression, will be assigned to one of three levels of IPT-M (high dose = weekly; medium dose = biweekly; low dose = monthly). After weekly acute and continuation treatment, subjects will be randomly assigned to one of the three IPT-M frequencies. We hypothesize that increased frequency of IPT-M will be associated with longer time to recurrence, and fewer instances of symptomatic exacerbation not meeting criteria for a new episode. We further hypothesize that, three variables are likely to moderate this effect: 1) women with low delta sleep ratio (number of delta wave counts in the first NREM period divided by number of delta wave counts in the second NREM period) will show shorter time to recurrence; 2) women with more severe life events will show shorter time to recurrence; and 3) women in patient/therapist dyads rated as low on specificity of IPT will show shorter time to recurrence. By limiting our investigation to those women with recurrent depression who respond to acute IPT, we hope to focus on the population most likely to seek and benefit from non-pharmacologic maintenance strategies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH049115-01
Application #
3388589
Study Section
Special Emphasis Panel (SRCM)
Project Start
1992-09-30
Project End
1997-08-31
Budget Start
1992-09-30
Budget End
1993-08-31
Support Year
1
Fiscal Year
1992
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Troxel, Wendy M; Kupfer, David J; Reynolds 3rd, Charles F et al. (2012) Insomnia and objectively measured sleep disturbances predict treatment outcome in depressed patients treated with psychotherapy or psychotherapy-pharmacotherapy combinations. J Clin Psychiatry 73:478-85
Mallinger, Alan G; Frank, Ellen; Thase, Michael E et al. (2009) Revisiting the effectiveness of standard antidepressants in bipolar disorder: are monoamine oxidase inhibitors superior? Psychopharmacol Bull 42:64-74
Lenze, Shannon N; Cyranowski, Jill M; Thompson, Wesley K et al. (2008) The cumulative impact of nonsevere life events predicts depression recurrence during maintenance treatment with interpersonal psychotherapy. J Consult Clin Psychol 76:979-87
Dombrovski, Alexandre Y; Cyranowski, Jill M; Mulsant, Benoit H et al. (2008) Which symptoms predict recurrence of depression in women treated with maintenance interpersonal psychotherapy? Depress Anxiety 25:1060-6
Kelly, Morgen A R; Cyranowski, Jill M; Frank, Ellen (2007) Sudden gains in interpersonal psychotherapy for depression. Behav Res Ther 45:2563-72
Frank, Ellen; Kupfer, David J; Buysse, Daniel J et al. (2007) Randomized trial of weekly, twice-monthly, and monthly interpersonal psychotherapy as maintenance treatment for women with recurrent depression. Am J Psychiatry 164:761-7
Troxel, Wendy M; Cyranowski, Jill M; Hall, Martica et al. (2007) Attachment anxiety, relationship context, and sleep in women with recurrent major depression. Psychosom Med 69:692-9
Scocco, Paolo; Frank, Ellen (2002) Interpersonal psychotherapy as augmentation treatment in depressed elderly responding poorly to antidepressant drugs: a case series. Psychother Psychosom 71:357-61
Harkness, Kate L; Frank, Ellen; Anderson, Barbara et al. (2002) Does interpersonal psychotherapy protect women from depression in the face of stressful life events? J Consult Clin Psychol 70:908-15
Buysse, D J; Hall, M; Begley, A et al. (2001) Sleep and treatment response in depression: new findings using power spectral analysis. Psychiatry Res 103:51-67

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