Telephone-administered psychotherapy reduces depression

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Psychotherapy delivered over the telephone reduces symptoms of Depression in patients with physical impairments due to multiple sclerosis, investigators report.

“The biggest advantage of ‘telemental health’ is that it overcomes barriers,” Dr. David C. Mohr, of the University of California at San Francisco, told Reuters Health. “Even in urban areas where mental health is available, there are a lot of barriers, such as physical disabilities, time constraints, transportation problems, or not being able to get away from home because of child care or elder care duties.”

Potential barriers to receiving psychotherapy include physical impairments preventing attendance, transportation problems, lack of available and appropriate services in the local area, childcare problems, lack of time, and lack of financial resources.

“To overcome geographic and other barriers to treatment and to save costs, many health maintenance organizations and care-providing institutions are expanding telemental health services, such as telephone-delivered psychotherapy,” observe David Mohr (University of California, San Francisco, USA) and colleagues.

While such therapies have proven superior to receiving no treatment, their efficacy has not been compared with that of non-specific telephone-administered supportive emotion-focused therapy (T-SEFT).

The researches therefore compared T-CBT, which teaches patients skills to help them manage cognitions and behaviors that contribute to Depression and improve skills in managing stressful life events and interpersonal difficulties, with T-SEFT over a 16-week period. All the patients spoke on the phone with a psychologist for 50 minutes each week and were followed-up for 12 months.

Of the 120 participants, who all had Depression and functional impairments due to multiple sclerosis, 59 were assigned to receive T-CBT. These individuals showed significantly greater improvement in depressive symptoms than those assigned to receive T-SEFT.

During the 16 weeks of treatment, scores on the Hamilton Rating Scale for Depression fell from an average of 21.35 to 11.98 points for those receiving T-CBT, while scores for those receiving T-SEFT fell from 21.66 points to just 14.81 points.

Superior improvements on the Positive Affect Scale were also seen for the T-CBT group, with scores improving by 6.56 points, compared with just 2.85 points for those receiving T-SEFT. However, there was no significant difference between the treatments on the Beck Depression Inventory.

The researchers note in the Archives of General Psychiatry that the treatment gains were retained during the 12 months of follow-up; however, differences across treatments were no longer evident at this time.

To expand on these benefits of telephone-administered psychotherapies, they say that “it will be important to examine if the outcomes of telephone-administered therapies are equivalent to face-to-face interventions.”

Source: Arch Gen Psychiatry 2005; 62: 1007–1014 - http://archpsyc.ama-assn.org/cgi/content/abstract/62/9/1007

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