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An Open-Label Trial of Interpersonal Psychotherapy in Depressed Patients With Coronary Disease

Received May 15, 2003; revision received Oct. 21, 2003; accepted Nov. 24, 2003. From the University of Ottawa Heart Institute and the Institute of Mental Health Research, Royal Ottawa Hospital; the Department of Psychiatry, School of Nursing, and the Department of Epidemiology and Biostatistics, McGill University, Montreal; the Department of Psychiatry, University of Montreal; the Centre Hospitalier de l'Université de Montreal Research Center, Montreal; and the Montreal Heart Institute Research Centre, Montreal. Address reprint requests to Dr. Koszycki, Stress and Anxiety Clinical Research Unit, Royal Ottawa Hospital, 1145 Carling Ave., Ottawa, Ont. K1Z 7K4 Canada; dkoszyck{at}rohcg.on.ca (e-mail).

High rates of depression have been reported in patients with coronary artery disease, and depression has been repeatedly shown to adversely affect cardiac morbidity and mortality. Despite these findings, little work has been devoted to evaluating effective antidepressant treatments for this subpopulation. This open-label trial assessed the efficacy and acceptability of interpersonal psychotherapy in depressed patients with stable coronary artery disease. Seventeen patients with coronary artery disease who met DSM-IV criteria for major depression received 12 weekly sessions of interpersonal psychotherapy. Outcome was assessed with the 17-item Hamilton Depression Rating Scale and the Beck Depression Inventory II. Ten patients received medication during the trial, and seven patients received interpersonal psychotherapy alone. The patients showed a significant reduction in scores on both the Hamilton depression scale and the Beck Depression Inventory II from baseline, with 53% of the patients meeting criteria for remission, as defined by scores of 7 and 14 on the Hamilton depression scale and the Beck Depression Inventory II, respectively. Medicated and unmedicated patients responded similarly to interpersonal psychotherapy. These data provide support for the potential use of interpersonal psychotherapy in depressed patients with coronary artery disease. The therapy was well tolerated and accepted by patients, with a high proportion achieving remission. Future randomized clinical trials are needed to establish its efficacy.

Key Words: depression • other psychotherapy • syndromes secondary to medical disorders

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