Review: The effectiveness of interpersonal psychotherapy for adolescents with depression - a systematic review and meta-analysis.

Abstract

Interpersonal psychotherapy for adolescents (IPT-A) is a manualised, time-limited intervention for young people with depression. This systematic review aimed to determine the effectiveness of IPT-A for treating adolescent depression. A systematic search of relevant electronic databases and study reference lists was conducted. Any study investigating the effectiveness of IPT-A in 12- to 20-year-olds with a depressive disorder was eligible. Synthesis was via narrative summary and meta-analysis. Twenty studies were identified (10 randomised trials and 10 open trials/case studies), many of which had small sample sizes and were of varying quality. Following IPT-A, participants experienced large improvements in depression symptoms (d=-1.48, p<.0001, k=17), interpersonal difficulties with a medium effect (d=-0.68, p<.001, k=8) and in general functioning with a very large effect (d=2.85, p<.001, k=8). When compared against control interventions, IPT-A was more effective than non-CBT active controls in reducing depression symptoms (d=-0.64, p<.001, k=5) and was no different from CBT (d=0.05, p=.88, k=2). There was no difference between IPT-A and active control interventions in reducing interpersonal difficulties (d=-0.26, p=.25, k=5). Interpersonal psychotherapy for adolescents is an effective intervention for adolescent depression, improving a range of relevant outcomes. IPT-A is consistently superior to less structured interventions and performs similarly to CBT. However, these conclusions are cautious, as they are based on a small number of controlled studies, with minor adaptations to the standard IPT-A protocol, and/or were conducted by the intervention developers. Further robust RCTs are therefore required. The lack of superiority in IPT-A for improving interpersonal difficulties highlights a need for studies to explore the underpinning mechanisms of change.