Advancing depression treatment: a multi-center randomized controlled trial of dynamic interpersonal therapy versus CBT and pharmacotherapy on symptoms, sleep, and cognition

Oct 24, 2025Psychiatry research

Comparing dynamic interpersonal therapy, CBT, and medication for depression symptoms, sleep, and thinking in a multi-center trial

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Dynamic Interpersonal Therapy (DIT) resulted in 38% long-term reductions in depressive symptoms and 45% in sleep disturbances.

DIT maintained stable long-term improvements in mood and sleep quality compared to Cognitive Behavioral Therapy (CBT) and pharmacotherapy.
Significant short-term improvements were observed in all three treatment groups.
DIT showed lasting advantages in cognitive functions such as inhibition, attention, flexibility, and processing speed.
CBT exhibited moderate long-term stability in outcomes, while pharmacotherapy was associated with symptom relapse.
These findings suggest DIT may be a more holistic treatment option for Major Depressive Disorder.

AI simplified

BACKGROUND: While Cogni Behavioral Therapy (CBT) and pharmacotherapy are widely recognized treatments for Major Depressive Disorder (MDD), Dynamic Interpersonal Therapy (DIT) remains underexplored, particularly regarding its long-term effects on symptom reduction, sleep quality, and cognitive functioning. Existing studies rarely compare these approaches across such multidimensional outcomes.

METHODS: In this multi-center randomized controlled trial (MC-RCT), 225 individuals diagnosed with Major Depressive Disorder (MDD) were randomly allocated to one of three structured 16-week treatment conditions comprising Dynamic Interpersonal Therapy (DIT), Cognitive Behavioral Therapy (CBT), or standard pharmacotherapy. The study was conducted across five primary care centers in Iran (Tehran, Tabriz, Shiraz, Isfahan, Mashhad), with follow-ups at 6 and 12 months. Outcomes were measured using the Hamilton Depression Rating Scale (HAM-d-17), Pittsburgh Sleep Quality Index (PSQI), and the Stroop Test. Data were analyzed via Mixed-Design ANOVA.

RESULTS: All three groups showed significant short-term improvements. However, only DIT maintained stable long-term reductions in depressive symptoms (38 %) and sleep disturbances (45 %). DIT also produced superior and lasting gains in cognitive inhibition, selective attention, cognitive flexibility, and processing speed. CBT showed moderate long-term stability, while pharmacotherapy was linked to symptom relapse and diminished cognitive outcomes.

CONCLUSIONS: DIT demonstrates durable, multidimensional benefits in treating MDD, outperforming CBT and pharmacotherapy in sustaining improvements in mood, sleep, and cognition. These findings highlight DIT's potential as a holistic and effective alternative, challenging symptom-focused models and informing future directions in depression care.

Full Text

Full text is available at the source.

View full text (XML) ↗View full text ↗

Advancing depression treatment: a multi-center randomized controlled trial of dynamic interpersonal therapy versus CBT and pharmacotherapy on symptoms, sleep, and cognition

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief