Interpersonal Psychotherapy in Russia: Remembering Past Losses of the Heart, Keeping Mindful of the Culture of Melancholy, and Reconnecting with a Supportive Social Environment.

ABSTRACT

BACKGROUND: The dissolution of the Soviet Union brought economic instability and variety of social changes, resulting in fluctuating suicide rates and highlighting the national phenomenon of a melancholy cultural trait across the general population. The socio-political changes in Russia post-1991 led to increased rates of depressive and stress-related disorders, as well as opening avenues for integrating foreign psychotherapeutic methods, including Interpersonal Psychotherapy (Klerman-Weissman IPT), into the treatment of mental disorders. This narrative review explores the adaptation and efficacy of IPT in Russia, particularly for depressive and stress-related disorders. MATERIAL AND METHODS: We assembled key PhD theses related to the topic of IPT use in Russia. One such study involved 120 female patients aged 23-45 years with adjustment disorders, treated at the Omsk Rehabilitation Treatment Hospital. Participants were divided into an IPT group (n=80) and a control group (n=40) receiving treatment as usual (TAU). The IPT group underwent 12-16 individual sessions, each lasting 60 minutes, held twice a week. The main study group was further divided into four sub-groups based on specific interpersonal problems loss of loved ones, interpersonal conflicts, social role changes, and social isolation. RESULTS: Both groups showed improvement in anxiety, dyssomnia, and motor retardation, with the IPT group demonstrating more sustained improvement. At the 8-week endpoint, full recovery from depression was observed in 50% of the IPT group, compared to only 20% in the TAU group. The IPT group also showed significant improvements in coping strategies, with a notable decrease in avoidance behaviors and an increase in problem-solving strategies, also targeting melancholy national phenomenon via training acceptance skills and practicing an active life position to aware the self-responisbility and achieve a of well-being state of emotional balance. The group IPT method was also experimentally combined with the person-oriented (reconstructive) psychotherapy, which has a long and successful history of within the group format, and has enabled shortening of the standard course of person-oriented reconstructive treatment. CONCLUSIONS: IPT method has proven efficacy in treating depressive and stress-related disorders in Russia, by addressing deeper pathogenetic levels of mental and behavioral formations. The Russian Society of Psychiatrists and Russian Psychotherapy Association have recommended its broader implementation in Russian mental health institutions, and has included IPT in the Russian National Guidelines for Psychiatry.