Interpersonal psychotherapy (IPT) is a time-limited, diagnosis-focused therapy. IPT was defined in a manual. Research has established its efficacy as an acute and chronic treatment for patients with major depressive disorder (MDD) of all ages, as an acute treatment for bulimia nervosa, and as adjunct maintenance treatment for bipolar disorder. The research findings have led to its inclusion in treatment guidelines and increasing dissemination into clinical practice. Demonstration of efficacy in research trials for patients with major depressive episodes (MDEs) has led to its adaptation and testing for other mood and non-mood disorders. This has included modification for adolescent and geriatric depressed patients patients with bipolar and dysthymic disorders; depressed HIV-positive and depressed pregnant and postpartum patients; depressed primary care patients; and as a maintenance treatment to prevent relapse of the depression. Most of the modifications have been relatively minor and have retained the general principles and techniques of IPT for major depression. Non-mood targets have included anorexia, bulimia, substance abuse, borderline personality disorder, and several anxiety disorders. In general, outcome studies of IPT have suggested its promise for most psychiatric diagnoses in which it has been studied, with the exceptions of anorexia, dysthymic disorder, and substance use disorders.
IPT has two complementary basic premises. First, depression is a medical illness, which is treatable and not the patient's fault. Second, depression does not occur in a vacuum, but rather is influenced by and itself affects the patient's psychosocial environment. Changes in relationships or other life events may precipitate depressive episodes; conversely, depressive episodes strain relationships and may lead to negative life events. The goal of treatment is to help the patient solve a crisis in his or her role functioning or social environment. Achieving this helps the patient to gain a sense of mastery over his or her functioning and relieves depressive symptoms.
Begun as a research intervention, IPT has only lately started to be disseminated among clinicians and in residency training programmes. The publication of efficacy data, the promulgation of practice guidelines that embrace IPT among antidepressant treatments, and economic pressures on length of treatment have led to increasing interest in IPT. This chapter describes the concepts and techniques of IPT and its current status of adaptation, efficacy data, and training. The chapter provides a guide to developments and a reference list, but not a comprehensive review.
Association between acute critical life events and the speed of onset of depressive episodes in male and female depressed patients