There are inherent limitations in the study design. Generalizability
and conclusions are limited by the small sample of all women, absence of comparative group analysis, heterogeneity
of medications, difficulty in differentiating psychotherapeutic
from pharmacological effects, and naturalistic clinical
practice design.Without a larger heterogeneous sample and a
comparative group, it is difficult to attribute the antidepressive
response entirely to IPSRT-G or to identify the specific
therapeutic factors contributing to symptom or functioning
improvement.