To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: CPA: Short-term Dynamic Psychotherapy May Deliver Good Results in Patients with Treatment-Resistant Depression URL: http://www.pslgroup.com/dg/222306.htm Doctor's Guide November 6, 2002
By Bonnie Darves Special to DG News BANFF, ALBERTA -- November 6, 2002 -- Patients who have failed to response to second- and third-line treatments may see some symptom improvement with introduction of intensive short-term dynamic psychotherapy, say researchers. This finding is from preliminary results of a new trial study presented here at the annual meeting of the Canadian Psychiatric Association. The findings are promising, the researchers said, because of the myriad of challenges psychiatrists face in working with treatment-resistant populations of patients with depression. Lead researcher Allan Abbass, MD, director of education in the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada, said that new approaches are warranted given the fact that the response rate to second- and third-line treatment is often less than 50 percent. He noted that short-term intensive psychotherapy treatment has been developed to treat patients with complex personality disorders and multiple symptoms, but that no formal qualitative research has been done in treatment-resistant depression to assess the efficacy of the approach. In Dr. Abbass' pilot study of depressed patients who have not responded to third-line treatments, patients undergo psychotherapy in a staged process that involves acquainting patients with their defense mechanisms and gradually weakening forces of resistance with repeated experience of feelings mobilized in the therapeutic process. This strategy, he said, helps patients "become more aware of emotions rather than internalizing them," and helps weaken the depression mechanism. At present, five patients with an average age of 51 years are involved in the study. Eight five percent have discontinued taking medication. Four of the patients had normalized Hamilton Depression Rating Scale (HAM-D), Clinical Global Impression (CGI) and self-reported improvements after 20 weeks, Dr. Abbass said, as well as Inventory of Interpersonal Problems scores "in the normal range. The HAM-D went down in the same curve as the symptom inventory. Many patients become frustrated as medications are added and there is no improvement" in symptoms, he said. In addition, two of the patients returned to work after a period of disability (and being off work) of two and seven years, respectively, and two who were not working have indicated they plan to return to work. Of those who have remained on some medication, doses have been reduced substantially over the 20 weeks, he said, indicating that psychotherapy may also be an economically attractive option in this population. "We know that psychotherapy saves $3 to $4 for every dollar spent on drugs, and if a patient is maintained that could be a savings of up to $1,200 a month," he said, adding that the cost of medication for the patients studied dropped from $820 to $120 (CDN) per month. "The treatment essentially paid for itself after in a matter of weeks, and there have been no adverse effects noted to this point," Dr. Abbass said. Post ratings were conducted every four weeks during the 24-week treatment period, and one- and two-year follow-ups are planned. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.