Interpersonal psychotherapy for Finnish community patients with moderate to severe major depression and comorbidities: A pilot feasibility study

Abstract

Objective: Interpersonal psychotherapy (IPT) has shown efficacy in randomized controlled trials. No reports exist on IPT for depressed patients with severe psychiatric comorbidities in public outpatient clinics. This pilot feasibility study assessed preliminary effectiveness and patient satisfaction with IPT for depressed patients with psychiatric comorbidities in municipal outpatient care in Turku, Finland. Because lengthy treatment strains mental healthcare resources, this trial also assessed the potential for IPT, a time-limited treatment, to discharge patients successfully. Method: Seven clinicians in two municipal clinics were briefly trained to deliver IPT, while clinicians in two other clinics provided treatment as usual (TAU). Twenty-six patients with moderate to severe major depressive disorder received IPT for 16 weeks, and a control group (n = 20) received TAU. Seventy-six percent of patients had concurrent anxiety disorders, 73% personality disorders and 20% alcohol dependence. As 61% of patients received concurrent pharmacotherapy, the study lacked statistical power to find outcome differences between treatment groups. Results: Depressive symptoms, social functioning and self-perceived health improved notably in both groups. The mean Hamilton Depression Rating Scale (HAMD) score decreased from 20 to 10. Using HAMD ≤ 7 as a cutoff, 28.3% of patients achieved remission. Patients receiving IPT reported significantly greater satisfaction with their treatment and were more often able to terminate treatment after 16 sessions. Conclusions: Both treatments were effective in this small, highly comorbid sample. Conducting IPT appeared feasible in municipal outpatient clinics and offered some advantages over TAU. It was possible to train staff quickly. These results warrant a further, larger randomized trial.