Maintenance IPT for Recurrent
Major Depression (IPT-M)
Depression tends to be a recurring illness: most people who suffer a single episode will likely have a second episode in their lifetimes. The more episodes an individual has suffered, the greater the likelihood of recurrence ( Keller et al., 1992). Frank and colleagues ( 1991) have carefully defined the terms remission, relapse, and recurrence for major depression. It is important not only to find treatments that work acutely, but to determine those that can forestall the return of a relapsing, recurrent condition such as major depression. Such prophylactic benefits have been demonstrated more clearly for antidepressant medications than for psychotherapies. Many depressed patients thus require treatment after their acute episode has resolved. Some are difficult to treat. Many have multiple marital, family, and other social problems and frequently use medical and social services ( Wells et al., 1989; Klerman, 1990).
In a landmark study, Frank, Kupfer, and colleagues at the University of Pittsburgh compared pharmacotherapy to psychotherapy as prophylaxis for 128 patients at high risk of depressive relapse ( Frank et al., 1989, 1990). IPT- M, a monthly maintenance form of IPT ( Frank, 1991), was the psychotherapy employed. This and a parallel study in Pittsburgh for geriatric depression ( Reynolds et al., 1999) are the only long-term maintenance studies of antidepressant psychotherapy published to date.