SANTA FE, N.M. -- Psychotherapy can work at least as well as medication, and often prevents relapse in mood disorder patients who do not do well on pharmacotherapy alone, Ellen Frank, Ph.D., said at a psychiatric symposium sponsored by the University of Arizona.
"All things being equal, if the patient is amenable to psychotherapy, that is where I would start first. The risk of relapse is probably lower," advised Dr. Frank, professor of psychiatry and psychology at the University of Pittsburgh.
She reported that 85%-89% of depressed patients are achieving remission in an ongoing trial that is being conducted at sites in Pittsburgh and in Italy.
The patients start on interpersonal psychotherapy (IPT) or pharmacotherapy, she said, and the alternative is added only for those who do not respond sufficiently to the initial treatment.
Results from another trial with bipolar patients are in press, according to Dr. Frank, who is the author of "Treating Bipolar Disorder: A Clinician's Guide to Interpersonal and Social Rhythm Therapy" (New York: Guilford Publications, 2005).
She said that she and her colleagues will report lower relapse rates and longer time to relapse for those who received interpersonal and social rhythm therapy (IPSRT), a combination of IPT and therapy aimed at regularizing daily routines of bipolar patients.
"It turned out IPSRT really is a preventative treatment," Dr. Frank said. "It turned out not to matter what patients got in the maintenance phase. Those who got acute IPSRT were significantly protected against new episodes of illness."
She also cited seven controlled trials conducted since 1974 that have shown IPT to be effective "as an acute, continuation, and maintenance treatment for patients with mild to moderately severe depression."
In one of her own studies, IPT produced 66% remission when combined with medication at the outset of treatment and 76% when the combination was offered to those who did not remit with IPT alone (J. …