Effectiveness of IPT Adapted for Depressed Women with Trauma Histories in a CMHC

Summary

Principal Investigator: Nancy Talbot
Affiliation: University of Rochester
Country: USA
Abstract: DESCRIPTION (provided by applicant): Evidence-based treatments for depression have rarely been studied in community settings where low income and ethnic minority patients receive care. Among the most in need of effective treatments are depressed women with histories of early interpersonal trauma, who suffer disproportionate burden characterized by chronic depression, multiple comorbidities, and marked interpersonal difficulties. The aim of the proposed randomized controlled trial (RCT), based in a community mental health center, is to evaluate the effectiveness of Interpersonal Psychotherapy-Trauma in Community Settings (IPT-TCS). IPT-TCS is Interpersonal Psychotherapy with modifications specifically designed for the treatment of depressed patients with trauma histories seen in community settings. Substantial pilot data providing preliminary support for IPTTCS and supporting the feasibility of the proposed RCT have been collected during the P.l.'s NIMH-K23 Career Development Award. An ongoing pilot RCT of IPT-TCS has demonstrated high rates of patient recruitment and acceptance of randomization. The proposed RCT (n=180) will compare IPT-TCS to treatment as usual (TAU) for women with major depression and histories of childhood sexual abuse. A hybrid efficacy-effectiveness design will be used. Urn randomization procedures will balance groups with respect to medication status;active post-traumatic stress disorder (PTSD);active anxiety disorder other than PTSD;fully-remitted substance use disorders;and, borderline personality disorder. Medication dosage and adherence, medication management visits, and case management visits will not be controlled by design, but will be controlled statistically in secondary analyses. We hypothesize that IPT-TCS will be more effective than TAU in reducing depression at 32-weeks after treatment assignment. Improvements in social functioning, health-related functioning, post-traumatic stress symptoms, and mental health functioning are also expected. To monitor post-treatment course, outcome variables will be assessed at 6-month intervals over a 2-year period, and longer-term effects will be examined via repeated-measure analyses. The proposed research is designed to provide definitive results regarding the effectiveness of IPT-TCS compared to usual care in a community mental health center. The next stage of our research program will be directed at transporting IPT-TCS and comparison therapies into community agencies.
Funding Period: 2007-09-14 - 2012-05-31
more information: NIH RePORT

Top Publications

  1. pmc Predictors of treatment outcomes among depressed women with childhood sexual abuse histories
    Natalie A Cort
    Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642, USA
    Depress Anxiety 29:479-86. 2012
  2. pmc Domain-specific social functioning improvements during treatment of depressed women with histories of childhood sexual abuse
    Stephanie A Gamble
    Department of Psychiatry, University of Rochester, Rochester, NY, United States
    J Affect Disord 130:478-82. 2011
  3. pmc Parental sexual abuse and suicidal behaviour among women with major depressive disorder
    Banu Cankaya
    Koc University, Istanbul, Turkey
    Can J Psychiatry 57:45-51. 2012
  4. pmc Childhood sexual abuse is associated with physical illness burden and functioning in psychiatric patients 50 years of age and older
    Nancy L Talbot
    Department of Psychiatry, Rochester Center for Mind Body Research, University of Rochester, School of Medicine and Dentistry, 300 Crittenden Blvd, Box PSYCH, Rochester, New York 14642, USA
    Psychosom Med 71:417-22. 2009

Scientific Experts

Detail Information

Publications5

  1. pmc Predictors of treatment outcomes among depressed women with childhood sexual abuse histories
    Natalie A Cort
    Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642, USA
    Depress Anxiety 29:479-86. 2012
    ..This exploratory study begins to address the gap in what is known about predictors of treatment outcomes among depressed women with sexual abuse histories...
  2. pmc Domain-specific social functioning improvements during treatment of depressed women with histories of childhood sexual abuse
    Stephanie A Gamble
    Department of Psychiatry, University of Rochester, Rochester, NY, United States
    J Affect Disord 130:478-82. 2011
    ....
  3. pmc Parental sexual abuse and suicidal behaviour among women with major depressive disorder
    Banu Cankaya
    Koc University, Istanbul, Turkey
    Can J Psychiatry 57:45-51. 2012
    ..We aimed to examine the contributions of abuse characteristics to lifetime history of suicide attempts and multiple suicide attempts, independent of posttraumatic stress disorder and borderline personality disorder...
  4. pmc Childhood sexual abuse is associated with physical illness burden and functioning in psychiatric patients 50 years of age and older
    Nancy L Talbot
    Department of Psychiatry, Rochester Center for Mind Body Research, University of Rochester, School of Medicine and Dentistry, 300 Crittenden Blvd, Box PSYCH, Rochester, New York 14642, USA
    Psychosom Med 71:417-22. 2009
    ..The health implications of abuse for mixed-gender samples of older psychiatric patients have not been explored...