Interpersonal and Social Rhythm Therapy Effective in Major Depressive Disorder

Interpersonal and social rhythm therapy (IPSRT), designed to stabilize daily routines as well as sleep and wake cycles, can improve mood and social functioning in patients with major depressive disorder (MDD), according to study results published in the American Journal of Psychotherapy.

Marie Crowe, RN, PhD, of the department of psychological medicine, University of Otago Christchurch, New Zealand, and colleagues conducted a preliminary safety analysis of a randomized controlled trial of patients with a recurrent mood disorder who reported current cognitive difficulties. Patients in the trial were randomly assigned to receive either IPSRT or IPSRT plus cognitive remediation. The study focused on the effects of IPSRT on the first 30 patients, who were divided into 2 groups: bipolar disorder (n=19; mean age, 42.3±11.8 years; 15 women) and MDD (n=11; mean age, 30.5±11.01 years; 6 women).

IPSRT involved weekly sessions for 10 to 12 weeks followed by biweekly and then monthly sessions. Therapists trained in IPSRT examined patients’ interpersonal patterns and social rhythms, as well as how they affected mood symptoms and interpersonal functioning. In both groups, investigators measured mood symptoms with the Longitudinal Interval Follow-Up Evaluation (LIFE) and the Quick Inventory of Depressive Symptoms Self-Report (QIDS-SR), as well as functioning with the Social Adjustment Scale (SAS) at baseline and 12-month follow-up.

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Patients with MDD showed improved mean depressive scores (LIFE: Cohen d =0.9; QIDS-SR: Cohen d =1.4) and improved functioning (SAS: Cohen d =0.7). Patients with bipolar disorder also demonstrated improved depressive symptoms (LIFE: Cohen d =0.6; QIDS-S: Cohen d =0.6) and improved functioning (SAS: Cohen d =0.4). Neither group reported adverse events; however, results should be interpreted with caution because of the small sample size.

The researchers noted that it was not possible to control for cognitive remediation in this study because the randomized controlled trial is still underway. In addition, the benefits of IPSRT in patients with MDD may be related to adjunctive cognitive remediation in half the patients.

“The use of IPSRT among patients with major depressive disorder has a strong theoretical rationale on the basis of the principles of chronobiology, and this study suggests that this therapy may be effective in practice,” the investigators concluded.


Crowe M, Inder M, Douglas K, et al. Interpersonal and social rhythm therapy for patients with major depressive disorder. Am J Psychother. 2020;73(1):29-34.