Can Dynamic Interpersonal Therapy Help Treat Depression?

What you need to know

• Dynamic interpersonal therapy (DIT) is a brief, structured form of psychotherapy developed to treat depression
• This study found DIT combined with antidepressants was more effective than antidepressants alone for treating major depression in China
• DIT showed similar effectiveness to general supportive therapy in the short-term, but may have longer-lasting benefits
• More research is needed to confirm the long-term advantages of DIT due to high dropout rates in the follow-up period

Background on depression and treatment in China

Major depressive disorder (MDD) is a common mental health condition that affects millions of people worldwide. In China, about 2.1% of adults experience depression in a given year. Depression can significantly impact a person’s quality of life and ability to function.

While antidepressant medications and psychotherapy are recommended treatments for depression in China, less than 20% of people with depression receive any treatment. There is a shortage of mental health resources, and psychotherapy is underutilized due to factors like high costs and lack of standardized treatments.

Dynamic interpersonal therapy (DIT) was recently developed as a brief, 16-session form of psychotherapy to treat depression. It focuses on helping patients understand how their depression relates to difficulties in relationships and patterns of thinking about themselves and others. While DIT has shown promise in some studies, its effectiveness had not been tested in China before this research.

About the study

This study aimed to evaluate whether DIT could be an effective treatment for major depression in China. The researchers conducted a randomized controlled trial comparing three treatment approaches:

1. DIT plus antidepressant medication
2. General supportive therapy plus antidepressant medication
3. Antidepressant medication alone

211 adults with major depression were randomly assigned to one of these three groups. They received 16 weeks of treatment and were then followed for 12 months afterward. The main measure was a standardized depression rating scale administered by trained evaluators who did not know which treatment each patient received.

Key findings

After 16 weeks of treatment:

• Patients who received DIT plus medication showed greater improvement in depression symptoms compared to those who only took medication
• About 57% of patients in the DIT group achieved remission (very low depression scores)
• DIT was similarly effective to general supportive therapy in reducing depression in the short-term

During the 12-month follow-up period:

• Patients who received DIT maintained lower depression scores compared to the medication-only group
• At the final 12-month assessment, the DIT group had lower depression scores than both other groups
• However, many patients dropped out during follow-up, making these longer-term results less certain

How DIT may help with depression

DIT aims to help patients in several key ways:

• Identifying problematic patterns in how they relate to others and themselves
• Understanding how these patterns connect to their depression symptoms
• Enhancing their ability to reflect on their own thoughts and feelings
• Improving their capacity to manage relationship difficulties underlying depression

The structured, time-limited nature of DIT (16 weekly sessions) may make it more feasible to implement in mental health systems with limited resources.

Comparing DIT to other treatments

This study found DIT was more effective than antidepressants alone, which aligns with previous research showing combined medication and psychotherapy is often superior to medication by itself for depression.

DIT and general supportive therapy showed similar effectiveness during the initial treatment period. This may be partly due to common beneficial factors shared by different types of psychotherapy, like having a supportive relationship with a therapist.

However, there were signs that DIT’s benefits may last longer after treatment ends. The researchers suggest this could be because DIT helps patients develop new ways of understanding themselves and their relationships that continue to be helpful over time. But more research is needed to confirm any long-term advantages.

Limitations and future directions

There were some important limitations to this study:

• Many patients dropped out during the follow-up period, especially in the medication-only group, making the long-term results less reliable
• The study was only conducted in Shanghai and nearby areas, so the results may not apply to all of China
• The researchers did not measure factors like the patient-therapist relationship that could influence treatment effectiveness

Future studies should:

• Find ways to keep more patients engaged in long-term follow-up
• Test DIT in other regions of China
• Examine how DIT affects other aspects of patients’ lives beyond just depression symptoms
• Compare DIT to other established psychotherapies for depression
• Assess the cost-effectiveness of DIT compared to other treatments

Conclusions

This study provides initial evidence that dynamic interpersonal therapy could be an effective treatment option for major depression in China when combined with antidepressant medication. DIT showed greater benefits than medication alone and may have longer-lasting effects than general supportive therapy. However, more research is needed to confirm these findings and determine which patients are most likely to benefit from DIT. Overall, this work represents an important step in expanding the range of evidence-based psychotherapy options available for treating depression in China.