Dynamic interpersonal therapy combined with antidepressant medication for college students with depression and...

Depressive disorders accompanied by insomnia represent a significant clinical issue among college students, negatively impacting their academic performance, quality of life, and overall mental health. Dynamic interpersonal therapy (DIT), a brief psychodynamic intervention, has shown promise in treating depression, but its efficacy in addressing insomnia comorbid with depressive disorders in this population remains unclear.

This study aimed to evaluate the effectiveness of dynamic interpersonal therapy combined with antidepressant medication (DIT combined with ADM) compared with antidepressant medication alone (ADM alone) in improving symptoms of depression and insomnia among college students.

This study was a randomized controlled trial enrolling 56 college students diagnosed with depressive disorder with comorbid insomnia. Participants were randomly assigned (1:1) to receive either DIT combined with ADM (16 weekly DIT sessions) or antidepressant medication alone, over a 16-week period. The primary outcome measure was the Insomnia Severity Index (ISI). Secondary outcomes included depressive symptoms (Patient Health Questionnaire-9, PHQ-9; Hamilton Depression Rating Scale-17, HAMD-17), anxiety symptoms (Generalized Anxiety Disorder-7, GAD-7; Hamilton Anxiety Rating Scale-14, HAMA-14), and sleep quality (Pittsburgh Sleep Quality Index, PSQI). Assessments were conducted at baseline, mid-treatment (8 weeks), post-treatment (16 weeks), and at a 1-month follow-up.

Significant improvements were observed in both groups over time. The between-subjects (treatment) effects revealed that the DIT combined with ADM group exhibited significantly greater reductions in insomnia severity (ISI: p = 0.002), depressive symptoms (PHQ-9: p = 0.031, HAMD-17: p = 0.026), anxiety (GAD-7: p = 0.035, HAMA-14: p = 0.046), and sleep quality (PSQI: p = 0.049) compared to the ADM-alone group. Both groups demonstrated significant within-subjects (time) effects, reflecting improvements across all outcomes. However, the DIT combined with ADM group showed superior outcomes, particularly after 8 weeks, with these effects being sustained at the 1-month follow-up.

DIT combined with antidepressant medication demonstrated superior efficacy compared to medication alone in alleviating insomnia, depressive symptoms, and anxiety, as well as in improving sleep quality among college students with depressive disorders. These results support the integration of DIT into standard clinical care to address co-occurring depression and insomnia in this vulnerable population. However, given the modest sample size and the single-center design, the findings should be regarded as preliminary. To confirm their generalizability and to further investigate the long-term benefits and underlying mechanisms of DIT, larger, multi-center trials are required.