Interpersoonlijke psychotherapie voor depressieve ouderen

Antidepressant medication is often the first choice treatment for depressed elderly patients. However evidence-based psychotherapies such as Interpersonal Psychotherapy (IPT) may be a good alternative. The problem is that such therapies are hardly available in primary care. This paper describes the results of a research project exploring the feasibility and effectiveness of delivering IPT by mental health workers within primary care practices. It turned out that it was feasible to deliver IPT transmurally. Furthermore, IPT was more effective than usual care in patients with moderate to severe depression, not in patients with mild depression. The results of this study are in line with other research on specific monotherapies for depression in primary care. The effectiveness of the monotherapies is modest, but depression care as a whole can be improved by implementing depression management programmes in which the different treatment options for depression are offered stepwise or in combination, taking account of the patient's preferences. In these collaborative care projects general practitioners are supported by nurses or mental health workers. It is argued that these programmes, that have proved to be effective in the US, should be studied in the Netherlands.