Interpersonal psychotherapy: current status

Interpersonal psychotherapy (IPT), a time-limited treatment for major depression, was developed, defined in a manual, and tested in randomized clinical trials by the late Gerald L Klerman, MD, and collaborators. It has subsequently been modified for different age groups (adolescents-elderly), types of mood disorders (dysthymia, bipolar disorder, antepartum and postpartum patients), and non-mood disorders (bulimia, drug abuse, borderline personality disorder, social phobia, somatization, medically ill patients). It has been used as a long-term treatment, in a group format, over the telephone, and as a patient guide. It has been translated into Italian, German and recently Japanese. Having begun as a research intervention, IPT is only recently being disseminated among clinicians or in residency training programs. The publication of efficacy data, the appearance of two practice guidelines in the United States that include IPT among treatments for depression, the interest in defined treatments for managed care and the endorsement of Consumers Guide have led to increasing requests for information and training. This paper briefly describes the concepts and techniques of IPT and the current status of adaptation. In summary, evidence from controlled clinical trials suggests that IPT is a reasonable alternative or adjunct to medication as an acute, continuation, and/or maintenance treatment for patients with major or mild depression, patients who are human immunodeficiency virus (HIV) positive, or who have bulimia. It is a promising treatment for depressed adolescents and for geriatric patients, for patients with dysthymia and as treatment for depressed couples marital disputes. A final conclusion awaits the completion of clinical trials underway before substantial claims can be made. IPT is not effective, as compared to a standard drug program, for opiate and cocaine addicted patients.