Interpersonal psychotherapy (IPT), a short-term treatment developed and tested for use with ambulatory depressed patients, has been successfully applied to elderly patients in a recent pilot study. Case reports of treated elderly patients are presented and the specific utility of IPT for this population is described. The potential of short-term psychotherapies for the treatment of the elderly is discussed and research directions are outlined.
Despite the fact that there is a high prevalence of depression among the elderly, little research on the efficacy of psychotherapy or pharmacotherapy with the elderly has been reported in the literature. This paper describes a sample of 18 elderly patients who received both psychotherapy and pharmacotherapy for the treatment of depression. Psychotherapy involved weekly 30-50 minutes sessions of interpersonal psychotherapy with a treating psychiatrist. The drug treatment consisted of random assignment, double-blind, to either alprazolam, imipramine, or pill-placebo for six weeks. The focus of therapy was on the attendance, compliance, and symptomatic relief in elderly depressed patients, as well as on the major life problems identified by these patients in psychotherapy. Results indicated that elderly patients respond to community publicity regarding a psychotherapy treatment program. However, the majority are inappropriate referrals for diagnostic reasons. If accepted, elderly patients showed good compliance with drugs, and attendance was comparable to that in younger populations. The elderly patients responded well to treatment, with immediate and marked improvement on the Hamilton and Raskin Depression Scales, which was maintained after treatment. Grief and role transitions specific to life changes were frequent antecedents to depression in this elderly population and thus were the major foci in psychotherapy.
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