Randomized controlled trial of interpersonal psychotherapy versus enhanced treatment as usual for women with co-occurring depression and pelvic pain

J Psychosom Res. 2014 Oct;77(4):264-72. doi: 10.1016/j.jpsychores.2014.07.016. Epub 2014 Jul 26.

Abstract

Objective: Our study assessed the effectiveness of Interpersonal Psychotherapy (IPT) tailored for biomedical patients with depression and pain. IPT was compared to enhanced treatment as usual (E-TAU) among women with co-occurring depression and chronic pain presenting for care at a women's health or family medicine practice. We hypothesized that women presenting to urban medical practices with depression and chronic pain would benefit from IPT tailored to address their needs to a greater degree than from E-TAU.

Methods: We conducted a randomized controlled psychotherapy trial of 61 women from 2 urban medical practices who met criteria for major depressive disorder and chronic pelvic pain. Participants were assigned to receive either 8 sessions of IPT or a facilitated psychotherapy referral to a community mental health center, and assessed for depression, social interactions, and pain at 0-, 12-, 24-, and 36-weeks, with score on the Hamilton Rating Scale for Depression as the primary outcome. Both intent-to-treat (ITT) and causal modeling analyses correcting for treatment attendance were conducted.

Results: ITT analyses were not significant. In causal modeling analyses, participants assigned to IPT showed significantly more improvement for depression and social interactions, but not for pain.

Conclusion: IPT may be a viable option as part of a comprehensive treatment program for women in medical practices with depression and chronic pain.

Clinical trials registration: ClinicalTrials.gov, NCT00895999.

Keywords: Chronic pain; Depression; Psychotherapy; Socioeconomic disadvantage; Women.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chronic Pain / complications*
  • Chronic Pain / epidemiology
  • Comorbidity
  • Depression / epidemiology
  • Depression / etiology
  • Depression / therapy*
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / etiology
  • Depressive Disorder, Major / therapy*
  • Family Practice
  • Female
  • Humans
  • Interpersonal Relations*
  • Middle Aged
  • Pelvic Pain / complications*
  • Pelvic Pain / epidemiology
  • Psychotherapy / methods*
  • Research Design
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Urban Population

Associated data

  • ClinicalTrials.gov/NCT00895999