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Progress in the psychotherapy of mood disorders: studies from the Western Psychiatric Institute and Clinic

Published online by Cambridge University Press:  11 October 2011

Ellen Frank  and
Danielle Novick
Ellen Frank*
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA
Danielle Novick
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA
*
Indirizzo per la corrispondenza: Dr. E. Frank, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213 (USA). Fax: +1-412-624-5734 E-mail: franke@msx. upmc. edu
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Summary

— During the last three decades, we have witnessed dramatic improvements in both the psychosocial and pharmacological treatments of affective disorders. Administered in concert with the new medications advances in pharmacology have produced, disorder-specific psychosocial treatments have further improved the prognosis and course of bipolar and unipolar disorder. Methods — We review our research on unipolar and bipolar disorder and their treatment, in particular interpersonal psychotherapy (IPT) and modifications thereof. Results — We provide empirical evidence that IPT is an efficacious acute and maintenance treatment for affective disorders. Our cumulative research and clinical experience suggest that interpersonal relations and circadian and social rhythms influence affective illnesses and that psychotherapy may aid in normalizing problems in these areas for patients with affective illnesses. Conclusions — Despite the excitement generated by the recent progress in research on mental disorders and their treatment, we are yet to fulfill the promise that the explosion of knowledge about targeted pharmacotherapies or psychotherapies would seem to offer. To move our field forward, we must continue to apply scientific rigor and thought to understanding the suitability of current nomenclatures, the impact of comorbid psychiatric and medical illnesses and symptoms on the manifestation and treatment of affective disorders, and the practicality of widespread utilization of new treatments.

Riassunto

— Durante gli ultimi tre decenni abbiamo assistito a significativi miglioramenti sia nei trattamenti psicosociali, sia in quelli farmacologici dei disturbi affettivi.Insieme ai progressi che i nuovi trattamenti farmacologici hanno prodotto, il trattamento psicosociale per la cura specifica del singolo disturbo ha ulteriormente migliorato la prognosi ed il decorso del disturbo bipolare e unipolare. Metodi — Rassegna delle nostre ricerche sul disturbo unipolare e bipolare e sul loro trattamento, in particolare la psicoterapia interpersonale (IPT) e le sue modificazioni. Risultati — Si fornisce la dimostrazione empirica che l'IPT à un trattamento per i disturbi affettivi efficace per la fase acuta e per il mantenimento. La nostra ricerca cumulativa e l'esperienza clinica suggeriscono che le relazioni interpersonali ed i ritmi circadiani e sociali influenzano i disturbi affettivi e che la psicoterapia pud aiutare a normalizzare i problemi in questi settori per i pazienti con disturbi affettivi. Conclusioni — Nonostante l'entusiasmo generato dai recenti progressi nella ricerca sui disturbi mentali e sul loro trattamento, dobbiamo ancora soddisfare l'impegno che l'enorme sviluppo delle conoscenze sulle farmacoterapie mirate e sulle psicoterapie sembrerebbero offrire. Per fare ulteriori progressi, dobbiamo continuare ad applicare rigore scientifico e riflessione per capire l'adattabilita delle attuali nomenclature, l'impatto delle malattie psichiche e mediche in comorbidità sulla manifestazione e sul trattamento dei disturbi affettivi e la praticabilita di un'ampia utilizzazione dei nuovi trattamenti.

Keywords

disturbi affettivipsicoterapia interpersonaleIPTaffective disordersinterpersonal therapyIPT
Type
Invited Papers
Information
Epidemiology and Psychiatric Sciences , Volume 10 , Issue 4 , December 2001 , pp. 245 - 252
Copyright
Copyright © Cambridge University Press 2001

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References

REFERENCES

Bearden, C., Lavalle, N., Buysse, D., Karp, J.F. & Frank, E. (1996). Personality pathology and time to remission in depressed outpatients treated with interpersonal psychotherapy. Journal of Personality Disorders 10, 164–173.CrossRefGoogle Scholar
Berlanga, C., Heinze, G., Torres, M., Apiquian, R. & Caballero, A. (1999). Personality and clinical predictors of recurrence of depression. Psychiatric Services 50, 376–380.CrossRefGoogle ScholarPubMed
Cassano, G.B., Michelini, S., Shear, M.K., Coli, E., Maser, J.D., & Frank, E. (1997). The panic-agoraphobic spectrum: a descriptive approach to the assessment and treatment of subtle symptoms. American Journal of Psychiatry 154, 27–38.Google Scholar
Coryell, W., Endicott, J., & Winokur, G. (1992). Anxiety syndromes as epiphenomena of primary major depression: outcome and familial psychopathology. American Journal of Psychiatry 149, 100–107.Google ScholarPubMed
Craighead, W.E., Miklowitz, D.J., Vajk, F.C. & Frank, E. (1998). Psychosocial treatments for bipolar disorder. In A Guide to Treatments Tliat Work (ed. Nathan, P.E. and Gorman, J.M.), pp. 240–248. Oxford University Press: New York.Google Scholar
Ehlers, C.L., Frank, E. & Kupfer, D.J. (1988). Social zeitgebers and biological rhythms: a unified approach to understanding the etiology of depression. Archives of General Psychiatry 45, 948–952.CrossRefGoogle ScholarPubMed
Ehlers, C.L., Kupfer, D.J., Frank, E. & Monk, T.H. (1993). Biological rhythms and depression: the role of zeitgebers and zeitstorers. Depression 1, 285–293.CrossRefGoogle Scholar
Feske, U., Frank, E., Kupfer, D.J., Shear, M.K. & Weaver, E. (1998). Anxiety as a predictor of response to interpersonal psychotherapy for recurrent major depression: an exploratory investigation. Depression and Anxiety 8, 135–141.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
Frank, E. (1991). Interpersonal psychotherapy as a maintenance treatment for patients with recurrent depression. Psychotherapy 28, 259–266.CrossRefGoogle Scholar
Frank, E. (1999). Interpersonal and social rhythm therapy prevents depressive symptomatology in bipolar 1 patients. Bipolar Disorders 1, 13.Google Scholar
Frank, E. & Spanier, C. (1995). Interpersonal psychotherapy for depression: overview, clinical efficacy, and future directions. Clinical Psychology: Science and Practice 2, 349–369.Google Scholar
Frank, E. & Thase, M. E. (1999). Natural history and preventative treatment of recurrent mood disorders. Annual Review of Medicine 50, 453–468.CrossRefGoogle ScholarPubMed
Frank, E., Kupfer, D.J., Perel, J.M., Comes, C., Jarrett, D.B., Mallinger, A.G., Thase, M.E., McEachran, A.B. & Grochocinski, V.J. (1990). Three-year outcomes for maintenance therapies in recurrent depression. Archives of General Psychiatry 47, 1093–1099.CrossRefGoogle ScholarPubMed
Frank, E., Kupfer, D.J., Wagner, E.F., McEachran, A.B. & Cornes, C. (1991). Efficacy of interpersonal psychotherapy as a maintenance treatment of recurrent depression: Contributing factors. Archives of General Psychiatry 48, 1053–1059.CrossRefGoogle ScholarPubMed
Frank, E., Kupfer, D.J. & Hamer, T. (1993). Maintenance therapies in recurrent depression: psychotherapy and combined treatment. In Recurrent Mood Disorders: New Perspective in Therapy (ed. Pla-cidi, G.F., Dell'Osso, L., Nistico, G. and Akiskal, H.S.), pp. 152–168. Springer-Verlag: New York.CrossRefGoogle Scholar
Frank, E., Kupfer, D.J., Ehlers, C.L., Monk, T.H., Cornes, C., Carter, S. & Frankel, D. (1994). Interpersonal and social rhythm therapy for bipolar disorder: integrating interpersonal and behavioral approaches. Behavior Therapist 17, 143–149.Google Scholar
Frank, E., Hlastala, S., Ritenour, A.M., Houck, P.R., Tu, X.M., Monk, T.H., Mallinger, A.G. & Kupfer, D.J. (1997). Inducing lifestyle regularity in recovering bipolar disorder patients: results from the maintenance therapies in bipolar disorder protocol. Biological Psychiatry 41, 1165–1173.CrossRefGoogle ScholarPubMed
Frank, E., Cassano, G.B., Shear, M.K., Rotondo, A., Dell'Osso, L., Mau-ri, M., Maser, J., & Grochocinski, V. (1998). The spectrum model: a more coherent approach to the complexity of psychiatric symptomatology. CNS Spectrum 3, 23–34.CrossRefGoogle Scholar
Frank, E., Swartz, H.A., Mallinger, A.G., Thase, M.E., Weaver, E.V. & Kupfer, D.J. (1999). Adjunctive psychotherapy for bipolar disorder: effects of changing treatment modality. Journal of Abnormal Psychology 108, 579–587.CrossRefGoogle ScholarPubMed
Frank, E., Grochocinski, V.J., Spanier, C.A., Buysse, D.J., Cherry, C.R., Houck, P.R., Stapf, D.M., & Kupfer, D.J. (2000a). Interpersonal psychotherapy and antidepressant medication: evaluation of a sequential treatment strategy in women with recurrent major depression. Journal of Clinical Psychiatry 61, 51–57.CrossRefGoogle ScholarPubMed
Frank, E., Shear, M.K., Rucci, P., Cyranowski, J.M., Endicott, J., Fagio-lini, A., Grochocinski, V.J., Houck, P., Kupfer, D.J., Maser, J.D. & Cassano, G.B. (2000b). Influence of panic-agoraphobic spectrum symptomatology on treatment response in patients with recurrent depression. American Journal of Psychiatry 157, 1101–1107.CrossRefGoogle Scholar
Frank, E., Swartz, H.A. & Kupfer, D.J. (2000c). Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Biological Psychiatry 48, 593–604.CrossRefGoogle ScholarPubMed
Frank, E., Winter, E., Rucci, P., Novick, D., Pilkonis, P., Houck, P., Mac-carelli, L.M. & Kupfer, D.J. (submitted for publication). Effects of maintenance interpersonal psychotherapy on levels of axis II pathology in patients with recurrent unipolar depression.Google Scholar
Grunhaus, L., Pande, A.C., Brown, M.B. & Greden, J.F. (1994). Clinical characteristics of patients with concurrent major depressive disorder and panic disorder. American Journal of Psychiatry 151,541–546.Google ScholarPubMed
Hlastala, S.A., Frank, E., Mallinger, A.G., Thase, M.E., Ritenour, A.M. & Kupfer, D.J. (1997). Bipolar depression: an underestimated treatment challenge. Depression and Anxiety 5, 73–83.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
Joyce, P., Mulder, R. & Cloninger, C.R. (1994). Temperament predicts clomipramine and desipramine response in major depression. Journal of Affective Disorders 30, 35–46.CrossRefGoogle ScholarPubMed
Keller, M.B., Lavori, P.W., Coryell, W., Endicott, J. & Mueller, T.I. (1993). Bipolar I: A five-year prospective follow-up. Journal of Nervous and Mental Disease 4, 238–245.CrossRefGoogle Scholar
Klerman, G.L., Di Mascico, A., Weissman, M.M., Prusoff, B.A. & Paykel, E.S. (1974). Treatment of depression by drugs and psychotherapy. American Journal of Psychiatry 131, 186–191.CrossRefGoogle ScholarPubMed
Klerman, G.L., Weissman, M.M., Rounsaville, B.J. & Chevron, E.S. (1984). Interpersonal Psychotherapy of Depression. Basic Books: New York.Google Scholar
Malinger, A.G. & Thase, M.E. (1997). Selected issues of bipolar disorder/best treatments for bipolar depression. Presented at the Mental Health Clinical Research Center Consultants Panel, Pittsburgh, PA.Annual Review of Medicine Chapter.Google Scholar
Markar, H.R. & Mander, A.J. (1989). Efficacy of lithium prophylaxis in clinical practice. British Journal of Psychiatry 155, 496–500.CrossRefGoogle ScholarPubMed
Markowitz, J.C. (1998). Interpersonal Psyclwtherapyfor Dysthymic Disorder. American Psychiatric Press: Washington, D.C.Google Scholar
Markowitz, J.C, Klerman, G.L., Clougherty, K.F., Spielman, L.A., Jacobsberg, L.B., Fishman, B., Frances, A.J., Kocsis, J.H. & Perry, S.W. (1995). Individual psychotherapies for depressed HIV-positive patients. American Journal of Psychiatry 152, 1504–1509.Google ScholarPubMed
Miller, M.D., Frank, E., Cornes, C., Imber, S.D., Anderson, B., Ehren-preis, L., Malloy, J., Silberman, R., Wolfson, L., Zaltman, J. & Rey-nolds, C.F. (1994). Applying interpersonal psychotherapy to bereavement-related depression following loss of a spouse in late life. Journal of Psychotherapy Practice and Research 3, 149–162.Google ScholarPubMed
Miller, M.D., Wolfson, L., Frank, E., Cornes, C., Silberman, R., Ehren-preis, L., Zaltman, J., Mallory, J. & Reynolds, C.F. (1998). Using interpersonal psychotherapy (IPT) in a combined psychotherapy/medication research protocol with depressed elders. Journal of Psychotherapy Practice and Research 7, 47–55.Google Scholar
Mueller, T.I., Leon, A.C., Keller, M.B., Solomon, D.A., Endicott, J., Coryell, W., Warshaw, M. & Maser, J.D. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. American Journal of Psychiatry 156, 1000–1006.CrossRefGoogle ScholarPubMed
Mufson, L., Moreau, D., Weissman, M.M. & Klerman, G.L. (1993). Interpersonal Psychotherapy for Depressed Adolescents. Guilford Press: New York.Google Scholar
Nelson, E. & Cloninger, C.R. (1997). Exploring the TPQ as a possible predictor of antidepressant response to nefazodone in a large multi-site study. Journal of Affective Disorders 44, 197–200.CrossRefGoogle Scholar
Pilkonis, P. & Frank, E. (1988). Personality pathology in recurrent depression: nature, prevalence, and relationship to treatment response. American Journal of Psychiatry 145, 435–411.Google ScholarPubMed
Prochaska, J.O. & Norcross, J. C. (1994). Interpersonal therapies. In Systems of Psychotherapy: a Transtheoretical Analysis, 3rd ed. (ed. Pro-chaska, J.O. and Norcross, J.C.), pp. 191–225. Brooks Cole: Pacific Grove.Google Scholar
Reynolds, C.F., Frank, E., Perel, J.M., Imber, S.D., Cornes, C., Miller, M.D., Mazumdar, S., Houck, P.R., Dew, M.A., Stack, J.A., Pollock, B.G. & Kupfer, D.J. (1999). Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression. Journal of the American Medical Association 281, 39–45.CrossRefGoogle ScholarPubMed
Schulberg, B.C., Block, M.R., Madonia, M.J., Scott, C.T., Rodriguez, E., Imber, S.D., Perel, J., Lave, J., Houck, P.R. & Coulehan, J.L. (1996). Treating major depression in primary care practice: Eight months clinical outcomes. Archives of General Psychiatry 53, 913–919.CrossRefGoogle Scholar
Shea, M.T., Widiger, T. & Klein, M. (1992). Comorbidity of personality disorders and depression: implications for treatment. Journal of Consulting Clinical Psychology 60, 857–868.CrossRefGoogle ScholarPubMed
Small, G.W., Hamilton, S.H., Bystritsky, A., Meyers, B.S., Nemeroff, C.B. & the Fluoxetine Collaborative Study Group. (1995). Clinical response predictors in a double-blind, placebo-controlled trial of fluoxetine for geriatric major depression. International Psychogeriatrics 7, 41–53.CrossRefGoogle Scholar
Spanier, C.A. & Frank, E. (1998). Maintenance interpersonal psychotherapy: a preventative maintenance. Interpersonal Psychotherapy (ed Markowitz, J.C.), pp. 461–475. American Psychiatric Press: Washington, D.C.Google Scholar
Swartz, H.A., Markowitz, J.C. & Frank, E. (in press). Interpersonal psychotherapy for unipolar and bipolar depression. In Psychological Treatments of Severe Mental Disorders (ed. Hofmann, S.G. and Thompson, M. C.).Google Scholar
Tasman, A. (1997). 20th Century. In Psychiatry (ed. Tasman, A., Kay, J. and Lieberman, J.A.), pp. 1865–1877. W. B. Saunders: Philadelphia, PA.Google Scholar
Tedlow, J., Fava, M., Uebelacker, L., Nierenberg, A.A., Aplert, J.E. & Rosenbaum, J. (1998). Outcome definitions and predictors in depression. Psychotherapy and Psychosomatics 67, 266–270.CrossRefGoogle ScholarPubMed
Thase, M.E. (1996). The role of axis II comorbidity in the management of patients with treatment-resistant depression. Psychiatric Clinics of North America 19, 287–309.CrossRefGoogle ScholarPubMed
Volz, H., Muller, H., Sturm, Y., Preubler, B. & Moller, H. (1995). Effect of initial treatment with antidepressants as a predictor of outcome after 8 weeks. Psychiatry Research 58, 107–115.CrossRefGoogle ScholarPubMed
Weissman, M.M., Kasl, S.V. & Klerman, G.L. (1976). Follow-up of depressed women after maintenance treatment. American Journal of Psychiatry 133, 757–760.Google ScholarPubMed
Weissman, M.M. & Markowitz, J.C. (1994). Interpersonal psychotherapy: current status. Archives of General Psychiatry 51, 599–606.CrossRefGoogle ScholarPubMed
Weissman, M.M., Markowitz, J.C. & Klerman, G.L. (2000). Comprehensive Guide to Interpersonal Psychotherapy. Basic Books: New York.Google Scholar