A 9-week, telephone-administered interpersonal psychotherapy intervention reduced depression in patients living with HIV in rural areas, accrding to a study published in Annals of Behavioral Medicine.
For people with HIV living in rural areas, it can prove difficult to easily access psychotherapy for depression. According to research from the University of Georgia, telephone-administered interpersonal psychotherapy (tele-IPT) can reduce depression over time for this patient population.
Rural areas account for 5% to 7% of all HIV infections in the US, and those living with HIV in rural areas are 1.3 times more likely to have a diagnosis of depression than those in urban settings, according to the authors of the study. Additionally, they are less likely to see a mental health provider and tend to make fewer visits to mental health professionals.
“IPT is a particularly apt time-limited psychotherapy for rural people living with HIV because it focuses on one’s interpersonal context, enhancing interpersonal skills, and increasing social supports,” wrote the authors. “IPT treats depressive symptoms by resolving a current interpersonal crisis related to the problem areas of role transition, interpersonal role dispute, grief, or interpersonal deficits.”
The study, published in Annals of Behavioral Medicine, built upon previous research from the group that found that tele-IPT acutely reduced depressive symptoms and interpersonal problems for the patient population significantly more than standard care over the course of 9 weekly sessions.
To assess the long-term effects, the authors reviewed self-administered surveys taken by 147 participants from 28 states at 4 and 8 months following the 9-week intervention. Using the surveys, the authors examined cognitive, affective, and somatic symptoms of clinical depression; interpersonal problems; perceived social support from family members and friends; and participation in self-help groups.
The first patient enrolled in August 2010, and the final 8-month follow-up was received in December 2015. On average, each participant participated in 7.8 tele-IPT sessions, and 82.1% attended all 9 sessions. At 4-month follow-up, fewer tele-IPT patients (28.1%) saw a healthcare professional in the last month compared with standard care patients (43.5%), and significantly more standard care patients (11.3%) used emergency hotlines compared with tele-IPT patients (1.6%).
The authors underscored the importance of this finding, noting that, prior to the intervention, many of the participants reported actively using treatment services for alcohol and drug dependence, other comorbid conditions, and financial and employment difficulties, which indicated that many of the participants confronted difficult medical and psychosocial complexities.
For tele-IPT participants, their clinical depression score (scale, 0-63) dropped from 26.7 to 21.71 at 4 months and to 20.55 at 8 months, whereas standard care patients’ scores dropped from 27.1 to 25.08 at 4 months and to 24.43 at 8 months.
Meanwhile, scores for interpersonal problems and perceived social support yielded no significant differences between the tele-IPT and standard care patients.
“The present study provides robust evidence that acute reductions in depressive symptoms following receipt of brief tele-IPT persist through longer term follow-up,” concluded the authors. “To counter the dearth of psychotherapies for rural people living with HIV, rural-based practitioners now have access to a brief, time-limited manualized treatment they can deliver to their clients that leverages the privacy and convenience of the telephone.”