Barriers and facilitators of treatment for depression in a latino community: a focus group study

We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician, and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes: vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments, healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead to interventions better able to meet the needs of this particular group.     

A randomized pilot study of psychotherapy and quetiapine for the acute treatment of bipolar II depression

Swartz HA, Frank E, Cheng Y. A randomized pilot study of psychotherapy and quetiapine for the acute treatment of bipolar II depression. Bipolar Disord 2012: 14: 211–216. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S. Objectives: The differential roles of psychotherapy and pharmacotherapy in the management of bipolar (BP) II depression are unknown. As a first step toward exploring this issue, we conducted a pilot study to evaluate the feasibility and acceptability of comparing a BP‐specific psychotherapy [Interpersonal and Social Rhythm Therapy (IPSRT)] to quetiapine as treatments for BP‐II depression. Methods: Unmedicated individuals (n = 25) meeting DSM‐IV criteria for BP‐II disorder, currently depressed, were randomly assigned to weekly sessions of IPSRT (n = 14) or quetiapine (n = 11), flexibly dosed from 25–300 mg. Participants were assessed with weekly measures of mood and followed for 12 weeks. Treatment preference was queried prior to randomization. Results: Using mixed effects models, both groups showed significant declines in the 25‐item Hamilton Rating Scale for Depression [F(1,21) = 44, p < 0.0001] and Young Mania Rating Scale [F(1,21) = 20, p = 0.0002] scores over time but no group‐by‐time interactions. Dropout rates were 21% (n = 3) and 27% (n = 3) in the IPSRT and quetiapine groups, respectively. Overall response rates (defined as ≥ 50% reduction in depression scores without an increase in mania scores) were 29% (n = 4) in the IPSRT group and 27% (n = 3) in the quetiapine group. Measures of treatment satisfaction were high in both groups. Treatment preference was not associated with outcomes. Conclusions: Outcomes in participants with BP‐II depression assigned to IPSRT monotherapy or quetiapine did not differ over 12 weeks in this small study. Follow‐up trials should examine characteristics that predict differential response to psychotherapy and pharmacotherapy.     

Barriers to treatment and service utilization in an internet sample of individuals with obsessive–compulsive symptoms

Background: Despite the increasing dissemination of treatment for Obsessive–Compulsive Disorder (OCD) in the past decade, the majority of individuals with OCD are not receiving appropriate treatment. This study examined rates of treatment utilization and barriers to treatment in an internet sample of individuals with self‐reported OCD. Methods: One hundred and seventy‐five participants completed an online survey examining OCD symptoms, psychosocial measures, barriers to treatment, and treatment utilization. Results: Sixty percent of the sample reported receiving treatment for their OCD symptoms. The majority of participants who sought pharmacotherapy received SSRIs, whereas the majority who sought psychotherapeutic treatment received “talk therapy.” The cost of treatment, lack of insurance coverage, shame, and doubt that treatment would be effective were the most commonly endorsed barriers to treatment among the sample. Conclusions: Findings demonstrated relatively low treatment utilization rates among the sample, with many participants receiving treatments other than the gold‐standard medication and psychotherapy treatments (i.e. SSRIs and cognitive behavioral therapy, respectively). Furthermore, a large portion of the sample endorsed many barriers to treatment seeking, such as logistic and financial barriers; stigma, shame, and discrimination barriers; and treatment perception and satisfaction barriers. This study highlights the need for more effective treatment dissemination in OCD. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.     

Further evidence for the efficacy of association splitting as a self-help technique for reducing obsessive thoughts

Background: Despite improved treatment options, many people with obsessive–compulsive disorder (OCD) do not seek or even actively avoid therapy due to shame or fear of stigmatization. Self‐help treatment is increasingly acknowledged as a means to “treat the untreated” and to motivate patients for face‐to‐face psychotherapy. Our group has gathered preliminary evidence for the efficacy of a novel self‐help approach entitled association splitting (AS) aimed at the reduction of obsessions. Methods: For this study, a total of 46 participants with a likely diagnosis of OCD were randomly allocated to either AS or a waitlist control (WL). Treatment consisted of the self‐study of a manual sent via e‐mail. At baseline and four weeks later symptoms were assessed online using the self‐report version of the Yale‐Brown Obsessive‐Compulsive Scale (Y‐BOCS), the Obsessive‐Compulsive Inventory‐Revised (OCI‐R), and the Beck Depression Inventory (BDI). Results: A total of 74% of the initial sample took part in the re‐assessment. Results were in accordance with prior uncontrolled data indicating that AS is a feasible approach leading to a symptom decline of approximately 25% on the Y‐BOCS. The technique also exerted a positive effect on depression (BDI) and the OCI‐R subscale obsessive thoughts. Conclusions: The study confirms the feasibility and efficacy of AS for a subgroup of patients with OCD. Ongoing studies explore whether short‐term effects are maintained over time and whether therapist‐guided therapy may enhance the efficacy of AS. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.     

Personality disorders improve in patients treated for major depression

Mulder RT, Joyce PR, Frampton CMA. Personality disorders improve in patients treated for major depression. Objective: To examine the stability of personality disorders and their change in response to the treatment of major depression. Method: 149 depressed out‐patients taking part in a treatment study were systematically assessed for personality disorders at baseline and after 18 months of treatment using the SCID‐II. Results: Personality disorder diagnoses and symptoms demonstrated low‐to‐moderate stability (overall κ = 0.41). In general, personality disorder diagnoses and symptoms significantly reduced over the 18 months of treatment. There was a trend for the patients who had a better response to treatment to lose more personality disorder symptoms, but even those who never recovered from their depression over the 18 months of treatment lost, on average, nearly three personality disorder symptoms. Conclusion: Personality disorders are neither particularly stable nor treatment resistant. In depressed out‐patients, personality disorder symptoms in general improve significantly even in patients whose response to their treatment for depressive symptoms is modest or poor.     

Sex differences in depressed university students

Summary Depressed males and females selected from a consecutive sample of students attending a university psychiatric service (N=183) and a sample from the general student population (n=55) were compared to determine why more females (ratio 21) seek help for depression. It was found that this sex difference was due neither to differential prevalence of depression nor to differences in symptom expression or social behavior, but rather to contrasting attitudes toward emotional problems and psychiatric help. Women recognize physical concomitants of depression as indicative of emotional problems and more readily accept the need for psychiatric help. Men appear not to connect physical symptoms with emotional difficulties.This research was funded by the Physician's Services Incorporated Foundation (Grant 821-76)     

Potential use of Internet‐based screening for anxiety disorders: a pilot study

Background: The Internet is a widely used resource for obtaining health information. Internet users are able to obtain anonymous information on diagnoses and treatment, seek confirmatory information, and are able to self‐diagnose. We posted a self‐report diagnostic screening questionnaire for DSM‐IV anxiety and mood disorders (MACSCREEN) on our clinic website. Method: Three hundred and two individuals completed the MACSREEN. For those who qualified for a DSM‐IV disorder, self‐report symptom severity measures were completed for the specified disorder: Quick Inventory of Depressive Symptomatology, self‐report, Social Phobia Inventory, GAD‐7, Davidson Trauma Scale, Panic and Agoraphobia Scale, and Yale/Brown Obsessive Compulsive Scale, self‐report. Cutoff scores for each self‐report measure were used to evaluate clinically significant symptom severity. Respondents were also asked to complete a series of questions regarding their use of the Internet for health information. Results: The mean age of the MACSCREEN sample was 35.2 years (±13.9), where the majority (67.2%) were female. The most frequently diagnosed conditions were social phobia (51.0%), major depressive disorder (32.4%), and generalized anxiety disorder (25.5%). Sixty‐five percent of the sample met criteria for at least one disorder. Most respondents reported completing the MACSCREEN, as they were concerned they had an anxiety problem (62.3%). The majority of respondents reported seeking health information concerning specific symptoms they were experiencing (54.6%) and were planning to use the information to seek further assessment (60.3%). Conclusion: Individuals with clinically significant disorder appear to be using the Internet to self‐diagnose and seek additional information. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.     

Psychological treatment of depression: Results of a series of meta-analyses

Background: In the past few decades, a considerable number of studies have examined the effects of psychotherapies for adult depression. Aim: We described the results of a series of meta-analyses examining what this large body of research has contributed to our knowledge of these treatments of depression. Results: We found that different types of psychotherapy are efficacious in the treatment of adult depression, including cognitive behavior therapy, interpersonal psychotherapy, problem-solving therapy, non-directive supportive therapy and behavioral activation therapy. Differences between types of psychotherapy are small. The efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of pharmacotherapy, and that combined treatment is more effective than psychotherapy alone and pharmacotherapy alone. Psychotherapy is not only effective in depressed adults in general, but also in older adults, women with postpartum depression, patients with general medical disorders, in inpatients, in primary care patients, patients with chronic depression and in subthreshold depression. Conclusions: We found no evidence showing that psychotherapy is less efficacious in severe depression (with mean baseline Hamilton Depression Rating Scale scores up to 31, mean Beck Depression Inventory scores up to 35.85 and mean Beck Depression Inventory-II scores up to 36.50), but effects are smaller in chronic depression. We also found that the effects of psychotherapy are probably overestimated because of publication bias and the relatively low quality of many studies in the field.     

Treating major depression by creating positive expectations for the future: a pilot study for the effectiveness of future-directed therapy (FDT) on symptom severity and quality of life

Introduction: This nonrandomized pilot study assesses the efficacy of a new future‐oriented form of therapy, known as future‐directed therapy (FDT), as a treatment for patients with Major Depressive Disorder (MDD) in a naturalistic hospital‐based outpatient psychiatry clinic. The study measured symptom severity of depression and anxiety, in addition to quality of life pre‐ and posttreatment. Aims: The study examined a new manualized treatment designed to help people anticipate a more positive future. The intervention consists of twenty 90‐min group sessions administered twice a week over 10 weeks. The intervention was compared to depressed patients in the same clinic who enrolled in traditional cognitive‐based group psychotherapy. Sixteen patients with MDD completed the FDT intervention as part of their outpatient treatment for depression. Seventeen patients with MDD participated in treatment as usual (TAU) cognitive‐based group therapy. The Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality‐of‐Life Enjoyment and Satisfaction Questionnaire short form, self‐report instruments were administered prior to and immediately after the completion of therapy. Results: Patients treated with FDT demonstrated significant improvements in depression (P= 0.001), anxiety (P= 0.021) and quality of life (P= 0.035), and also reported high satisfaction with the therapy. Compared to the TAU group, patients treated with FDT showed greater improvements in depressive symptoms (P= 0.049). Conclusions: FDT may have the potential of becoming an additional treatment option for patients with MDD.     

Adolescents’ Attitudes and Opinions about Depression Treatment

The purpose of this study was to determine adolescent preferences for depression treatment. Adolescents (n = 156) completed a survey that included: their preferences for type of depression treatment and the method of delivering it; their perception of the importance of side effects of depression treatments and a rating of their willingness to seek treatment if they were depressed. A screen for depressive symptoms (CES-D10) was also completed. Adolescents showed higher preference for psychotherapy than antidepressants. Greater severity of depression symptoms, perceived social support for the particular treatment modality, and general willingness to seek treatment predicted greater preference for psychotherapy than for antidepressants. Family doctors, psychiatrists, and psychologists were the preferred treatment providers, and adolescents preferred that treatment be delivered in a private office. Weight gain was the most deterring side effect of antidepressants for girls and loss of sex drive for boys. Adolescents’ preference for psychological therapy suggests that broader availability of psychotherapy may enhance help-seeking and compliance in depression treatment in this vulnerable population.     

Feedback-seeking and depression in survivors of domestic violence

Background: Not surprisingly, women in violent relationships often experience symptoms of depression. Although most people desire praise and positive feedback, individuals who are depressed often seek either negative or “even‐handed” self‐relevant information. The relative lack of positive feedback‐seeking exhibited by depressed individuals may have implications for understanding the difficulty that survivors of domestic violence have leaving and remaining apart from abusive partners. Methods: This study was designed to assess the relative preference for self‐relevant information in two groups of women: women who experienced domestic violence (DV group) and women who did not have these experiences (no‐DV group). Results and Conclusions: The DV group (n=30), relative to the no‐DV group (n=28), desired less positive (or relatively more negative) feedback. Further, depression mediated the relationship between DV and seeking less positive feedback. Motivational and cognitive explanations for this pattern of results are discussed. Depression and Anxiety, 2008. © 2008 Wiley‐Liss, Inc.     

Connectivity between mPFC and PCC predicts post‐choice attitude change: The self‐referential processing hypothesis of choice justification

Prior research shows that after making a choice, decision makers shift their attitudes in a choice‐congruous direction. Although this post‐choice attitude change effect is robust, the neural mechanisms underlying it are poorly understood. Here, we tested the hypothesis that decision makers elaborate on their choice in reference to self‐knowledge to justify the choice they have made. This self‐referential processing of the choice is thought to play a pivotal role in the post‐choice attitude change. Twenty‐four young American adults made a series of choices. They also rated their attitudes toward the choice options before and after the choices. In support of the current hypothesis, we found that changes in functional connectivity between two putative self‐regions (medial prefrontal cortex and posterior cingulate cortex/precuneus]) during the post‐choice (vs. pre‐choice) rating of the chosen options predicted the post‐choice shift of the attitudes toward the chosen options. This finding is the first to suggest that cognitive integration of various self‐relevant cognitions is instrumental in fostering post‐choice attitude change. Hum Brain Mapp 37:3810–3820, 2016. © 2016 Wiley Periodicals, Inc .     

A controlled trial of a school-based Internet program for reducing depressive symptoms in adolescent girls

Background: This study evaluates the benefits of a self‐directed Internet intervention for depression (MoodGYM) delivered as a part of the high school curriculum. Method: One hundred and fifty‐seven girls, aged 15 and 16 years, were allocated to undertake either MoodGYM or their usual curriculum. MoodGYM's impact on depressive symptoms, risk of depression, attributional style, depression literacy and attitudes toward depression was examined using random effect regression. Results: MoodGYM produced a significantly faster rate of decline in depressive symptoms over the trial period than the control condition. The effect size for MoodGYM was not significant immediately after the intervention (Cohen's d=.19, 95% CI ?.18–.56) but was moderate and significant 20 weeks after the intervention (d=.46, 95% CI .10–.82). Girls with high depression scores before intervention showed the strongest benefits on self‐reported depression at follow‐up (d=.92, 95% CI .10–1.38). There were no significant intervention effects on depression status, attributional style, depression literacy, and attitudes. Approximately 70% of girls in the MoodGYM group completed less than three of its modules and completion of fewer modules was related to high depression score before intervention. Conclusions: The findings suggest that there are benefits from MoodGYM on self‐reported depressive symptoms but has low rates of completion highlight problems in ensuring adherence to Internet programs for depression. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.     

Perspectives of young people on depression: awareness, experiences, attitudes and treatment preferences

Aim: Ascertaining current knowledge and attitudes towards depression among young people is vital for developing campaigns promoting community awareness and early intervention. Methods: Cross‐sectional computer‐assisted telephone interviews of persons aged 18–90 years were conducted by beyondblue in Australia in 2002 and 2004/05. Items assessed consideration of depression as a major general health or mental health problem, knowledge about prevalence of depression, usual age of onset for depression or anxiety and treatment preferences. Results: The surveys included 2003 and 3200 persons, respectively, with 285 and 400 aged between 18 and 25 years. Depression was not recognized by young persons as a major general health problem (1–2% of responses), but was the most frequently named mental health problem (37–42%). Younger persons were more likely than older persons to see depression as the major mental health problem, placing less emphasis on alcohol and other drug problems. They preferred first to seek help from family or friends (61–65%) and try non‐pharmacological treatments. Although understanding of the helpfulness of several evidence‐based treatments was good, many younger respondents still considered non‐evidence‐based treatments to be helpful. A quarter of subjects believed antidepressant medications were harmful and that alcohol use may be helpful. Conclusions: Although knowledge about depression was good, young people do not recognize depression as a major general health problem and remain reluctant to use professional services. These attitudes represent significant barriers to seeking treatment early in the course of common mental health problems.     

Atypical depression: retrospective self‐reporting of treatment effectiveness

Objective: Earlier studies demonstrated that those with atypical depression show a differentially superior response to monoamine oxidase inhibitor (MAOI) antidepressants. This study compares ratings of effectiveness for a range of treatments, amongst depressed subjects with and without atypical features. Method: In an on‐line survey, individuals experiencing likely clinical depression rated symptoms experienced when depressed, including ‘atypical features’ and the effectiveness of previous treatments. Mean treatment effectiveness ratings were compared amongst those with ‘atypical depression’ (n = 338) and ‘non‐atypical depression’ (n = 377). Results: There were few significant differences between the ‘atypical depression’ and ‘non‐atypical depression’ groups in effectiveness ratings for drug treatments, and none for psychological treatments. The ‘atypical depression’ group had significantly lower mean effectiveness ratings for some selective serotonin reuptake inhibitor antidepressants. Few respondents had trialed MAOIs. Conclusion: While MAOIs are rarely prescribed, a range of non‐MAOI drug and psychological treatments are of some perceived benefit for depressed patients with atypical features.     

Barriers to psychotherapy among depressed and nondepressed primary care patients

Background: Most primary care patients who experience depression state that they would prefer psychotherapy over antidepressant medications. However, when referrals for psychotherapy are made, only 20% ever follow up, and of these, half drop out of treatment. This suggests that there are substantial barriers to accessing psychotherapy.Purpose: The aim of this study was to investigate perceived barriers to psychotherapy in a sample of primary care patients and to test the hypothesis that these barriers would be more common among patients with depression.Methods: Patients were sampled from a large primary care service and mailed a survey. The survey included evaluation of barriers using items identified in previous published research, which we refer to as Perceived Barriers to Psychotherapy (PBP). Depression was measured using the Perceived Health Questionnaire-9 (PHQ-9).Results: Of the 904 surveys sent, 290 (32.1%) were returned. The PBP produced two factors—practical barriers and emotional barriers—explaining 58.2% of the variance with an internal reliability of α?= .79. Among all patients, 59.5% reported at least one barrier that would make it very difficult or impossible to participate in psychotherapy. Depression was associated with increased frequency of perceived barriers, with 74.0% of depressed patients reporting one or more barriers, versus 51.4% of nondepressed patients (p = .008). One or more perceived practical barriers were reported by 56.6% of the sample, whereas only 11.1% reported perceived emotional barriers. Depression was consistently associated with increased emotional barriers. Practical barriers were not consistently associated with depression but were influenced by history of psychotherapy.Conclusions: The majority of primary care patients surveyed reported one or more perceived barriers that would interfere with or prevent initiation or regular attendance of psychotherapy. Perceived barriers were more common among depressed than nondepressed patients making depression both an indicator for psychotherapy and a barrier to receiving it.     

Temperament and character predictors of depressed mood over a 4‐year interval

Background: A large community sample [n=591, 57% women, M age=51.01] was administered the Revised Temperament and Character Inventory [TCI‐R; Cloninger, 1999]: The Temperament and Character Inventory—Revised. St. Louis, MO: Center for Psychobiology of Personality, Washington University] and a modified version of the Center for Epidemiologic Studies–Depression Scale [CES‐D; Radloff, 1977]: Appl Psychol Measure 1:385–401] at Time 1 [T₁] and the Center for Epidemiologic Studies–Depression Scale again 4 years later at Time 2 [T₂].Methods: Whereas three of the seven personality dimensions were significantly and uniquely associated with depressed mood at T₁, only harm avoidance emerged as a significant unique positive predictor of depressed mood at T₂. Results: When participants were grouped according to the level of stability versus change in depressed mood during the 4‐year period, reward dependence, self‐directedness, and cooperativeness were found to be significantly lower among those low in depressed mood at T₁ who subsequently evidenced moderate to high levels of depressed mood at T₂ when compared to those with low depressed mood on both assessment occasions. Additional analyses indicated that those who evidenced moderate to high levels of depression at T₁ and T₂ were distinctly higher on harm avoidance and lower on self‐directedness when compared to those who had consistently low or variable levels of depressed mood across the two assessment occasions. Conclusions: Findings from this research are discussed in terms of personality‐related vulnerability and risk factors for future episodes of depressed mood. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Third-person effects and direct-to-consumer advertisements for antidepressants

Background: This study examines the evidence for a third‐ person effect (TPE) in the reactions of individuals affected by depression to direct‐to‐consumer (DTC) advertisements for antidepressants. TPE predicts that people will perceive the self to be less vulnerable to such advertisements than others. Previous research has identified such an effect, but did so in general population surveys. Past Previous research has also found a link between depression and diminished self‐serving biases; whether this would be the case for TPE is unknown. Methods: An online questionnaire was administered to 148 participants in an Internet depression support group to investigate their perceptions of the influence of direct‐to‐consumer (DTC) advertisements for antidepressants. Results: Consistent with expectations derived from third‐person effect TPE research, participants, although relatively neutral in their attitudes toward such advertisements, nevertheless perceived other individuals with depression as more influenced than themselves. Positive attitudes towards DTC advertisements and depressive symptoms at the time of the survey were each negatively associated with this third‐person perception (TPE). Conclusions: Individuals who have been diagnosed with depression and who participated in an online depression support group believe that they are less vulnerable to the influence of DTC advertisements than the typical person with a history of depression. This is moderated by attitudes towards DTC advertisements as well as by depressive symptoms, each of which is associated with a weakened TPE. Depression and Anxiety, 2011. © 2010 Wiley‐Liss, Inc.     

Physician willingness to refer older depressed patients for psychotherapy

OBJECTIVE: Psychotherapy for late-life depression is an efficacious treatment option for older primary care patients who do not wish to take or do not respond to antidepressant medication. However, rates of physician referral to psychotherapy to treat late-life depression tend to be low. The purpose of this study was to assess attitudes toward psychotherapy for late-life depression and to identify predictors of physician willingness to refer older patients to psychotherapy. METHODS: Two hundred and five physicians identified from PPO directories of general internists in California and North Carolina completed a brief mailed survey about how they would treat a hypothetical older depressed patient and specific attitudes and practices regarding their own treatment of late-life depression. RESULTS: Only 27 percent of physicians said they would refer a depressed older patient to psychotherapy. In a regression analysis, female gender, the belief that psychotherapy is effective for older adults, and physician use of psychosocial techniques were associated with increased willingness to refer to psychotherapy. Practicing in North Carolina, awareness of depression treatment guidelines, and the perception of patient willingness to attend psychoeducational classes on depression and medication management were associated with decreased willingness to refer. CONCLUSIONS: More efforts are needed to increase the use of referral to psychotherapy as a treatment option for older medical patients. Education about guideline-level treatment alone may not be sufficient. More specific education, including information about the efficacy of psychotherapy for older adults, as well as direct training in psychosocial techniques, may be helpful in promoting referral to psychotherapy.     

Efficacy of interpersonal therapy‐group format adapted to post‐traumatic stress disorder: an open‐label add‐on trial

Background: Post‐traumatic stress disorder (PTSD) is a highly prevalent condition, yet available treatments demonstrate only modest efficacy. Exposure therapies, considered by many to be the “gold‐standard” therapy for PTSD, are poorly tolerated by many patients and show high attrition. We evaluated interpersonal therapy, in a group format, adapted to PTSD (IPT‐G PTSD), as an adjunctive treatment for patients who failed to respond to conventional psychopharmacological treatment. Methods: Research participants included 40 patients who sought treatment through a program on violence in the department of psychiatry of Federal University of São Paulo (UNIFESP). They had received conventional psychopharmacological treatment for at least 12 weeks and failed to have an adequate clinical response. After signing an informed consent, approved earlier by the UNIFESP Ethics Review Board, they received a semi‐structured diagnostic interview (SCID‐I), administered by a trained mental health worker, to confirm the presence of a PTSD diagnosis according to DSM‐IV criteria. Other instruments were administered, and patients completed out self‐report instruments at baseline, and endpoint to evaluate clinical outcomes. Results: Thirty‐three patients completed the trial, but all had at least one second outcome evaluation. There were significant improvements on all measures, with large effect sizes. Conclusions: IPT‐G PTSD was effective not only in decreasing symptoms of PTSD, but also in decreasing symptoms of anxiety and depression. It led to significant improvements in social adjustment and quality of life. It was well tolerated and there were few dropouts. Our results are very preliminary; they need further confirmation through randomized controlled clinical trials. Depression and Anxiety, 2010. © 2009 Wiley‐Liss, Inc.