Anxiety as a predictor of response to interpersonal psychotherapy for recurrent major depression: An exploratory investigation

Abstract

Major depression and anxiety frequently co‐occur, but the implications for psychological treatments have rarely been studied. We examined predictors of acute response to interpersonal psychotherapy in 134 consecutively treated female outpatients with recurrent unipolar depression. Women who failed to remit with interpersonal psychotherapy alone experienced higher levels of somatic anxiety, were more likely to meet criteria for lifetime panic disorder, were more likely to meet criteria for nonendogenous or nonmelancholic depression, and reported greater vocational impairment, higher levels of global severity, a longer duration of the index episode, and, somewhat surprisingly, lower levels of social impairment at pretreatment evaluation. A series of backwards stepping logistic regression analyses showed higher levels of baseline somatic anxiety and social functioning to be the most consistent predictors of nonresponse. Our findings strengthen existing evidence that concomitant anxiety can adversely affect the outcome of interpersonal therapy for depression. Depression and Anxiety 8:135–141, 1998. © 1998 Wiley‐Liss, Inc.

Anxiety impairs depression remission in partial responders during extended treatment in late-life

“…Contrary to our hypothesis and previous findings [36], we did not observe diminished response to IPT during the extension phase based upon severity of pre-treatment anxiety. Other studies have observed reductions in anxiety during treatment with IPT for social phobia [37] and post traumatic stress disorder [38].…”

A Randomized Controlled Trial of Culturally Relevant, Brief Interpersonal Psychotherapy for Perinatal Depression

“…There was a trend showing that social functioning and anxiety symptoms also improved more in the IPT-B group than in the usual care group between baseline and three months postbaseline (before childbirth), but these findings were not significant (p=.063 and .051). We were also particularly interested in the prevalence of anxiety disorders among our participants, given the stressful context of their lives and the empirical evidence that comorbid anxiety delays treatment response to IPT for recurrent major depression (59). Inasmuch as 56% of the IPT-B participants had at least one anxiety disorder, including 28% with PTSD and 20% with panic disorder, we might expect that they would show a slower or minimal response to treatment (41), but this did not appear to be the case.…”

Treating co-occurring depression and anxiety: Modeling the dynamics of psychopathology and psychotherapy using the time-varying effect model.

“…As compared to patients with depression alone, anxious-depressed patients suffer from greater impairments in psychosocial and health related functioning (Brown et al, 1996; Roy-Byrne et al, 2000; Van Valkenburg et al, 1984), higher rates of depression relapse and recurrence (Albus et al, 1995; Roy-Byrne et al, 2000; Coryell et al, 2012; Forand et al, in press), and greater risk of suicide (Fava et al, 2004; Fawcett et al, 1990; Johnson et al, 1990; Roy-Byrne et al, 2000). Critically, these patients also demonstrate diminished rates of full treatment response/remission to both psychotherapeutic (Brown et al, 1996; Feske et al, 1998; Frank et al, 2000; Smits et al, 2012; but see also Fournier et al, 2009) and pharmacologic depression interventions (Brown et al, 1996; Fava et al, 2008). Thus, the weight of the extant evidence suggests that co-occurring anxiety adversely affects the typical efficacy of depression interventions.…”