Interpersonal therapy (IPT) has been shown to be effective for the treatment of postpartum depression. Typically this treatment is delivered in person; however given limited access to specialized providers, recent research has explored the feasibility and effectiveness of treatments delivered remotely. A recent study looks at the use of IPT for the treatment of postpartum depression as delivered by nurses over the telephone.
This study recruited 241 postpartum women with major depressive disorder (confirmed using the Structured Clinical Interview for DSM-IV (SCID-I) from 36 Canadian public health regions in rural and urban settings. Women were randomly assigned to 12 weekly, one hour sessions of nurse-delivered telephone IPT.
After 12 weeks, 10.6% of women in the IPT group (11/104) and 35% in the control group (35/100) remained depressed (OR = 0.22, 95% CI 0.10-0.46) as indicated using the SCID. Women receiving IPT were 4.5 times less likely to be clinically depressed.
According to scores on the Edinburgh Postnatal Depression Scale (EPDS), 21.2% in the IPT group and 51% in the control group had scores >12 (OR = 0.26, 95% CI 0.14-0.48) after 12 weeks of treatment. Attachment avoidance decreased more in the IPT group than in the control group (P = 0.02). None of the IPT responders relapsed by 36 weeks.
The results from this study indicate that nurse-delivered telephone IPT is an effective treatment for diverse urban and rural women with postpartum depression. While it can be delivered remotely, this modality of treatment will require considerable training. Hopefully, we will soon have a manual that outlines the treatment so that others groups can learn this useful technique.
Ruta Nonacs, MD PhD
Dennis CL, Grigoriadis S, Zupancic J, Kiss A, Ravitz P. Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: nationwide randomised controlled trial. Br J Psychiatry. 2020 Feb 7:1-8.