Foci of interpersonal psychotherapy (IPT) in depressed elders: Clinical and outcome correlates in a combined IPT/nortriptyline protocol

The primary problem areas or foci of interpersonal psychotherapy (IPT) in elders with recurrent major depression, the clinical correlates of single and multiple IPT foci, and their relationship to acute clinical response are described. 127 consecutive elderly patients (mean age 67.9, sd = 6.0) participating in the open (i.e., nonblind, nonrandomized) acute and continuation phases of a controlled maintenance therapies protocol were treated with combined IPT and nortriptyline. Multivariate analysis of variance was used to contrast the clinical and demographic profiles associated with different IPT foci. Kaplan-Meier survival analysis, stratifying on primary IPT focus, and by single versus multiple foci, was used to assess rapidity of response to treatment. We found no association between IPT focus (interpersonal dispute, role transition, or grief) and probability of recovery, or time to clinical response, under conditions of open combined treatment, nor between multiple versus single IPT foci, despite important pretreatment differences in clinical correlates of primary problem areas. Recovery from recurrent major depression using combined therapy is equally likely whether the IPT focus is multiple or single, grief-related, or based on a recent role transition or interpersonal dispute.