Interpersonal psychotherapy — structured clinical viva

You are the psychiatry registrar. A 41-year-old teacher with recurrent major depression has remitted twice on escitalopram but relapsed 4 months after each discontinuation. Current episode followed their mother’s death 9 months ago; they ‘kept busy and never really cried,’ then became anhedonic and socially withdrawn. They ask whether IPT is ‘better than CBT’ and whether they must stop medication to start therapy. Discuss IPT principles, problem-area selection, phase structure, landmark evidence (including maintenance and meta-analysis), comparison with CBT, and combined care for recurrent depression.