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Dynamic Interpersonal Therapy for moderate to severe depression: a pilot randomized controlled and feasibility trial

Fonagy, P; Lemma, A; Target, M; O'Keeffe, S; Constantinou, M; Ventura Wurman, T; Luyten, P; ... Pilling, S; + view all (2019) Dynamic Interpersonal Therapy for moderate to severe depression: a pilot randomized controlled and feasibility trial. Psychological Medicine 10.1017/S0033291719000928. (In press). Green open access

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Abstract

Background: Improving Access to Psychological Therapy (IAPT) services treat most patients in England who present to primary care with major depression. Psychodynamic psychotherapy is one of the psychotherapies offered. Dynamic Interpersonal Therapy (DIT), is a psychodynamic and mentalization-based treatment for depression. 16 sessions are delivered over approximately 5 months. Neither DIT’s effectiveness relative to low-intensity treatment (LIT), nor the feasibility of randomizing patients to psychodynamic or cognitivebehavioural treatments (CBT) in an IAPT setting, has been demonstrated. Methods: 147 patients were randomized in a 3:2:1 ratio to DIT (n = 73), LIT (control intervention; n = 54) or CBT (n = 20) in four IAPT treatment services in a combined superiority and feasibility design. Patients meeting criteria for major depressive disorder were assessed at baseline, mid-treatment (3 months) and post-treatment (6 months) using the Hamilton Rating Scale for Depression (HRSD-17), Beck Depression Inventory-II (BDI-II) and other self-rated questionnaire measures. Patients receiving DIT were also followed up 6 months post-completion. Results: The DIT arm showed significantly lower HRSD-17 scores at the 6-month primary end-point compared with LIT (d = 0.70). Significantly more DIT patients (51%) showed clinically significant change on the HRSD-17 compared with LIT (9%). The DIT and CBT arms showed equivalence on most outcomes. Results were similar with the BDI-II. DIT showed benefit across a range of secondary outcomes. Conclusions: DIT delivered in a primary care setting is superior to LIT and can be appropriately compared with CBT in future RCTs.

Type: Article
Title: Dynamic Interpersonal Therapy for moderate to severe depression: a pilot randomized controlled and feasibility trial
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0033291719000928
Publisher version: https://doi.org/10.1017/S0033291719000928
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10072038
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