Biomedical subjects

Ellen Frank

Publications and source records attributed to Ellen Frank.

93 records · Page 6Linked to original sources

PubMedDate not supplied

Interpersonal psychotherapy as augmentation treatment in depressed elderly responding poorly to antidepressant drugs: a case series.

BACKGROUND: Medication is often the first choice in the treatment of depression, even though large numbers of depressed patients do not respond to antidepressant drugs or fail to achieve symptom remission or recovery. Generally, other drugs, rather than other therapeutic approaches such as psychotherapy, are used as augmentation treatment. This applies in particular to elderly patients. The aim of this work is to assess whether augmentation with interpersonal psychotherapy (IPT) can bring about symptom remission in depressed elderly responding poorly to medication. METHOD: Five cognitively intact patients aged over 60 and suffering from major depression were first treated for 6 weeks with a selective serotonin reuptake inhibitor compound. Owing to poor outcome, IPT was added to the treatment. IPT is a brief psychotherapy addressing the interpersonal problems linked to depression, and has been modified for use with elderly patients. RESULTS: All patients achieved symptom remission after a cycle of psychotherapy lasting a minimum of 16 and a maximum of 20 weekly sessions. CONCLUSIONS: The methodological limitations of this open study do not allow us to generalize from the positive outcomes. Further studies might confirm these initial observations and establish whether an equally satisfactory therapeutic response can be attained if medication is discontinued after the start of psychotherapy.

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PubMedDate not supplied

Patient beliefs predict response to paroxetine among primary care patients with dysthymia and minor depression.

BACKGROUND: Dysthymia and minor depression are common problems in primary care, but it is not known how patient health beliefs shape response to antidepressant treatment of these less severe forms of depression. METHODS: Three hundred thirty-three primary care patients with dysthymia or minor depression received at least 4 weeks of paroxetine or placebo in a multicenter, randomized controlled 11-week trial. Patient health beliefs and other characteristics were examined as predictors of treatment adherence and depression remission. RESULTS: Patient beliefs were not predictive of adherence to paroxetine or placebo. Patients with less endorsement of biological beliefs about their condition (odds ratio [OR] = 3.40), higher perceived general health (OR = 3.38), meeting criteria for dysthymia (OR = 2.37), and age younger than 60 years (OR = 2.68) were more likely to achieve remission on paroxetine. Patient beliefs did not predict remission on placebo. Those with lower severity of depression symptoms at baseline (OR = 2.70) and women (OR = 2.18) were most likely to achieve remission on placebo. CONCLUSIONS: Our results suggest that patients with dysthymia or minor depression are more likely to respond to antidepressant medication if they do not see their depression as a biological illness and see themselves as generally healthy. It is clearly not necessary for patients to believe that their dysthymia or minor depression is biological to respond to antidepressant medication.

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PubMedDate not supplied

The value of maintenance interpersonal psychotherapy (IPT) in older adults with different IPT foci.

OBJECTIVE/METHODS: The authors examined recurrence rates of major depression in elderly subjects with different foci of interpersonal psychotherapy (IPT), who were treated for up to 3 years with either monthly maintenance IPT and pill placebo or with monthly clinical management and pill placebo. RESULTS: Among subjects with an IPT focus on role conflict, a greater proportion of those treated with maintenance-IPT survived for 3 years without recurrence than those treated with placebo/clinical management. Median time to recurrence was 68.9 weeks in IPT-treated patients versus 16.3 weeks for patients in clinical management. Subjects with an IPT focus on abnormal grief or role transition demonstrated no effect differential for maintenance IPT and pill-placebo on recurrence prevention over supportive clinical management and pill-placebo. CONCLUSION: If replicated in a larger sample, these findings have important implications for ongoing case-management decisions.

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