Novel coronavirus disease 2019 (COVID-19) was first found in Wuhan, China, and it has rapidly spread worldwide since the end of 2019. There is an urgent need to treat the physical and psychological aspects of COVID-19. Interpersonal psychotherapy (IPT)-based psychological intervention is an evidence-based therapy for depression and post-traumatic stress disorder.

This report describes a case of COVID-19 in a patient who transmitted the disease to his entire family. The patient received four sessions of IPT-based psychological intervention. We used the Hamilton Rating Scale for Depression and Patient Health Questionnaire to measure depression level, and the Hamilton Anxiety Scale and Generalized Anxiety Disorder to measure anxiety among the patients.

This case shows that IPT-based therapy can reduce COVID-19 patient depression and anxiety and the advantage of IPT-based therapy.

At the end of 2019, a new strain of human coronavirus emerged in Wuhan, China and has since spread worldwide. This disease is now known as coronavirus disease 2019 (COVID-19). COVID-19 is a major public health concern because little is known about the virus, and it causes serious damage to the lungs and may be fatal. The experience with severe acute respiratory syndrome showed that severe epidemics can bring psychological as well as physical trauma. During quarantine, patients with COVID-19 cannot see their families and friends, which contributes to their fear and loneliness and may reduce the effectiveness of their treatment. COVID-19 has induced negative emotions, such as anxiety, depression, insomnia, denial, anger, fear, and stress, that affect medical staff, patients, and the general public at different levels[1-3].

Interpersonal psychotherapy (IPT) is a time-limited method of psychotherapy. It was originally developed for the treatment of depression. Later, it was applied to other mental and associated diseases by focusing on patients’ social and interpersonal functions[4-6]. IPT was developed by Klerman and Weissman[7,8] in the 1980s and originated from theories of sociology, attachment, and communication. Based on the interpersonal theories of Sullivan[4] and Meyer[9] and several empirical studies, interpersonal stress is connected with the onset of depression. IPT focuses on relationships and is based on the theory that personal relationships play a key role in psychological problems. Even if relationships are not the cause of psychological problems, psychological problems can and may affect relationships and create new problems that are associated with interpersonal communication. As a result, we can alleviate psychological problems by improving interpersonal communication. By focusing on the current situation instead of searching for subconscious origins and looking at how more immediate difficulties contribute to the symptoms, IPT works in many areas such as grief, interpersonal disputes, psychological dysfunction due to life transitions, social isolation, and social deficits via techniques of interpersonal adjustment. The success of IPT in a series of randomized clinical trials has led to treatment of a variety of subtypes of depression and other psychiatric syndromes[9]. IPT also has effectiveness in treating social anxiety disorder, post-traumatic stress disorder (PTSD), eating disorders, and bipolar disorder.

In the COVID-19 pandemic, IPT has shown some advantages. First, the acute form of IPT, which is 12-16 wk of treatment, is a focused, practical, and proven time-limited form of psychotherapy. There are some benefits to this, such as fitting the timeline of the quarantine and saving money for the patients. Second, compared with other therapists, IPT therapists are more active and non-neutral. The treatment is time-limited, and as a result, the therapists need to be more efficient. IPT therapists play an active role during treatment with a focus on the problem area and implementation of interventional skills, such as practical suggestions, role-play, and psychoeducation. Third, IPT focuses on current symptoms and recent relationships and life events. IPT uses a medical model on psychiatric illness, seeing that the symptoms are caused by the disease instead of the patients’ themselves, to prevent the patients from feeling frustrated or guilty for their emotional or mental disorders. Fourth, IPT is always linked to mood and events and links the symptoms to specific interpersonal problems.

In the present case, most symptoms arose from the family, so IPT was well suited. This report describes four sessions of IPT-based psychological intervention in a patient who infected his entire family with COVID-19.

The final diagnosis was COVID-19.

Considering that the patient’s situation was mainly caused by the specific circumstances and his relationship with his family, the psychotherapist selected IPT to treat the patient’s psychological symptoms after talking with the clinician. IPT is time limited and change-oriented and aims to change interpersonal relationships to improve patients’ mental state. The psychotherapist knew that the patient’s antiviral therapy was imminent and that the IPT had to fit with that timeline. After discussion with the patient, the therapist proposed three IPT sessions in total. After IPT, the patient’s mood was significantly improved.

The depression and anxiety in this patient with COVID-19 were improved after the IPT-based therapy.

IPT benefits patients who are suffering from PTSD as well as depression. IPT is based on interpersonal theories and has been effective under controlled research conditions to treat a variety of disorders. Two large randomized controlled trials showed that IPT can produce improvement among people with major depression[10,11]. The fact is that many patients who suffer from depression believe that interpersonal problems contributed to the onset of their illness. IPT has also been used for treatment of other comorbid disorders[9]. Bleiberg et al[12] developed a model of individual IPT for PTSD that yielded improvement in symptoms. A United States National Institute of Mental Health-funded and randomized controlled study compared different treatments for PTSD and demonstrated the efficacy of IPT[13,14].

The present case report demonstrated the use of IPT-based psychological intervention for a patient with COVID-19, whose problems were mainly caused by family interpersonal relationships. GAD-7, PHQ-9, HAMD-17, and HAMA were used to assess improvement of symptoms and showed the effectiveness of IPT-based psychological intervention. The evidence-based IPT worked in this case through three sessions. Treatment of COVID-19 usually does not take long, and the patient’s mood during the process had an impact on treatment of physical diseases. When patients feel helpless, in some extreme cases, they even think of suicide, and we need to provide timely psychological intervention for those patients. IPT is time limited and was found to be a good choice in patients with COVID-19.

As COVID-19 has spread around the world, it has led to a psychological crisis, and psychological intervention is needed urgently. Patients, families, and medical staff are all at the risk of developing psychological problems.

Not all crises lead to PTSD. Although many factors are involved in PTSD, some researchers have proposed that the interpersonal features may influence the onset, chronicity, and treatment of PTSD[14,15]. IPT supposes that interpersonal relationships are affected by crises, and problems related to interpersonal relationships exacerbate the problems. IPT deals with problem areas: Grief or complicated bereavement, interpersonal conflicts, role transition, and interpersonal deficits[16,17]. In the present case, the problem area was interpersonal conflicts, and he benefited from IPT within a few weeks. This case reminds us that IPT is efficacious and has advantages of being time limited, the therapists are active and non-neutral, have a current focus, and investigate the link between mood and events. IPT provides rapid, relationship-based, short-term therapy.

Some studies have shown that the onset of COVID-19 may affect neurological symptoms[18]; however in this case, no neurological disease or symptoms were found. IPT is effective in this case, but it is still unknown whether it is able to be extended to patients with neurological disorders. Although during the epidemic period, we also adopted a lot of online remote intervention methods, in this case, it is still that the doctor interviewed the patient face-to-face with a set of isolation clothes for the doctor. As a result, however, we may have neglected whether wearing isolation clothes will affect the therapy in the emergency. This gives us the idea that in the future we can ask the patients about the feeling of conversing with a psychotherapist wearing isolation clothes[19].

There was a decrease in the assessment scores after therapy, which shows that IPT-based therapy can reduce COVID-19 patient depression and anxiety. This report also demonstrated the effectiveness and advantage of IPT-based therapy in COVID-19 patients.