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 Table of Contents  
COMMENTARY
Year : 2021  |  Volume : 5  |  Issue : 4  |  Page : 153-154

Interpersonal psychotherapy reaches out


Diane Goldman Kemper Family Professor of Epidemiology and Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Mailman School of Public Health, Chief Division of Translational Epidemiology, New York State Psychiatric Institute, 1051 Riverside Drive Unit 24, New York, New York 10032, USA

Date of Submission17-Aug-2021
Date of Acceptance30-Sep-2021
Date of Web Publication30-Nov-2021

Correspondence Address:
Prof. Myrna M Weissman
Diane Goldman Kemper Family Professor of Epidemiology and Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Mailman School of Public Health, Chief Division of Translational Epidemiology, New York State Psychiatric Institute, 1051 Riverside Drive Unit 24, New York, New York 10032
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/hm.hm_54_21

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How to cite this article:
Weissman MM. Interpersonal psychotherapy reaches out. Heart Mind 2021;5:153-4

How to cite this URL:
Weissman MM. Interpersonal psychotherapy reaches out. Heart Mind [serial online] 2021 [cited 2022 Jan 20];5:153-4. Available from: http://www.heartmindjournal.org/text.asp?2021/5/4/153/331571



The article by Wanhong Zheng, M.D., entitled “Interpersonal psychotherapy knowledge dissemination in China”, is on disseminating interpersonal psychotherapy (IPT) in China, in a journal on the Heart and Mind, with a special interest in this issue on the COVID-19 pandemic. This article published in this journal is a testimony to the universal importance of human attachment to health across cultures.

First, let me explain IPT and then relate its relevance to the topics. IPT was developed by myself and my late husband, Gerald Klerman, M.D., a Professor at Harvard University and a U.S. presidential appointee, for 4 years, to lead the Alcohol, Drug Abuse, and Mental Health Administration in Washington DC. IPT was developed at a time when psychotherapies were widely used but were lacking scientific testing. They had not been tested in clinical trials and were not described in procedural manuals. The validity and accuracy of the procedures could not be assured in the training of therapists and in the clinical testing or in practice. The situation has changed dramatically over the years. There are several evidence-based psychotherapies. Cognitive Behavioral Therapy (CBT) is the best known. There are now about 150 well-designed clinical trials of IPT, numerous translations from over the world, training programs of therapists from different professions, adaptations for depression and other psychiatric disorders, and dissemination by the World Health Organization (www.who.int). Information about IPT can be found in these books and articles.[1],[2],[3]

The basic principle behind IPT is that depression and distress may have an underlying biological and likely genetic basis, but the onset and recurrence of symptoms occur in an interpersonal context. Understanding that context, called the problem areas, and finding productive ways of dealing with them, through the IPT strategies, with a therapist, can help reduce both the problems and the symptoms.

The problem areas are defined as:

  • Grief, the death of a loved one
  • Disputes, disagreements with someone important that are either overt or smoldering disagreements or are leading to the end of the relationship
  • Transitions, life changes and disruptions that change personal relationships, or roles in daily living
  • Loneliness, paucity of relationships that are meaningful and supportive.


The strategies for determining and dealings with these problem areas are defined in the IPT manual. While there may be cultural nuances to the context of these problems and their solutions, we have found high acceptance of these problem area definitions across diverse cultures all over the world. The problem areas are reported to be meaningful to our participants' lives wherever they live.

What are the implications of IPT for COVID-19?

There are numerous reports of an increase in the rates of depression, distress, and anxiety disorders since the pandemic. We cannot confirm the precise numbers and how they vary across the globe. But, consider the death rate, the restriction of living arrangements, and travel, the social restrictions of gatherings of friends, coworkers, and family due to COVID-19. The IPT problem areas developed and tested many years ago are the template for the social consequences of COVID-19. There have not yet been controlled clinical trials that apply IPT to persons experiencing COVID, but there are strong data that IPT can deal with the psychosocial problem area generated by COVID-19.

What is the connection of IPT to a journal, the Heart and Mind, mainly aimed at cardiologists?

The developers of this journal have astutely recognized the important clinical relationships between cardiac health and mental health. There is considerable evidence from clinical and epidemiological studies that close social relationships are associated with a decrease in morbidity and mortality in a variety of medical conditions. The corollary is that a disruption in close attachments through deaths and disputes, life changes, or a paucity of attachment can be associated with increased morbidity, particularly the emergence of major depression. The scientific literature demonstrating this relationship is huge. I have cited just a few articles.[4],[5],[6],[7] The importance of sturdy social attachment has led the National Institute of Health to develop a toolbox to collect patient information on social supports at medical visits.[8]

We cannot promise that IPT will reduce cardiac problems or prevent them from happening. There have not been clinical trials. However, the evidence that troubled social attachments are risk factors for medical problems, including cardiac disease, is strong. IPT is one possible way of handling the problems of lost, absent, or troubled social attachments. While we come from different parts of the globe, different scientific and clinical specialties, our connections are not that obscure.



 
  References Top

1.
Weissman MM. Interpersonal psychotherapy: History and future. Am J Psychother 2020;73:3-7.  Back to cited text no. 1
    
2.
Weissman MM, Markowitz JC, Klerman GL. The Guide to Interpersonal Psychotherapy: Updated and Expanded Edition. Oxford University Press; 2017.  Back to cited text no. 2
    
3.
Ravitz P, Watson P, Lawson A, Constantino MJ, Bernecker S, Park J, et al. Interpersonal psychotherapy: A scoping review and historical perspective (1974-2017). Harv Rev Psychiatry 2019;27:165-80.  Back to cited text no. 3
    
4.
Strom JL, Egede LE. The impact of social support on outcomes in adult patients with type 2 diabetes: A systematic review. Curr Diab Rep 2012;12:769-81.  Back to cited text no. 4
    
5.
Compare A, Zarbo C, Manzoni GM, Castelnuovo G, Baldassari E, Bonardi A, et al. Social support, depression, and heart disease: A ten year literature review. Front Psychol 2013;4:384.  Back to cited text no. 5
    
6.
Lett HS, Blumenthal JA, Babyak MA, Strauman TJ, Robins C, Sherwood A. Social support and coronary heart disease: Epidemiologic evidence and implications for treatment. Psychosom Med 2005;67:869-78.  Back to cited text no. 6
    
7.
Choi KW, Stein MB, Nishimi KM, Ge T, Coleman JR, Chen CY, et al. An exposure-wide and Mendelian randomization approach to identifying modifiable factors for the prevention of depression. Am J Psychiatry 2020;177:944-54.  Back to cited text no. 7
    
8.
Cyranowski JM, Zill N, Bode R, Butt Z, Kelly MA, Pilkonis PA, et al. Assessing social support, companionship, and distress: National Institute of Health (NIH) Toolbox Adult Social Relationship Scales. Health Psychol 2013;32:293-301.  Back to cited text no. 8
    




 

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