Lots of interesting things to report since my last post -- so today is a catch up day.
1. Reporting on a study done in Finland, Dr Shock MD PHD gives us this:
Long-term psychodynamic psychotherapy is superior in the long term to short-term psychodynamic psychotherapy. Short-term produces benefits more quickly than long-term therapies. After 3 years of follow-up, however, the situation was reversed with a stronger treatment effect in the long-term psychodynamic treatment group both for patients with depressive and anxiety symptoms.
If a patient is capable and will benefit from psychodynamic psychotherapy which should be assessed by professionals before hand, than this kind of treatment to my opinion can be of great help to them not only for their complaints but also on the longer term.
Now this study doesn't surprise me at all. Cognitive behavioral therapy gained support because it is easy to design studies of it and because it fits with the current dominant paradigm in psychology and mental health. Insurance companies prefer it because it is short term. It is fairly easy to teach. So I love this longer term outcome study revealing that deeper work has better long term results.
2. Be sure to read this entry from Steve Diamond in his Psychology Today blog which he concludes :
I submit that depression is not a disease that should be treated in the same way as say, diabetes (which itself is known in many cases to be stress-related). It is a biopsychosocial syndrome requiring far more than pharmacological intervention. The unfortunate fact that most contemporary psychotherapy--including CBT--fails to penetrate to the heart of the Hydra in major unipolar and bipolar depression underscores the desperate need for more effective psychotherapy rather than proving a biological cause for these devastating disorders.
Yup. Meds can, but do not always help with symptoms, but long lasting change requires getting inside and working on what it is that creates the depression in the first place.
3. More less than rosy news about medications, this study --"The persistence of the placebo response in antidepressant clinical trials" --
Abstract
Our objective was to assess the persistence of the placebo response during at least 12 weeks of continued placebo administration in depressed patients who have responded to 6–8 weeks of acute placebo treatment. We identified 8 placebo-controlled antidepressant trials with a total of 3063 depressed patients in which, after acute phase placebo treatment, placebo was continued for more than 12 weeks. The number of patients entering the continuation phase and percentages relapsing during this phase were determined. Based on the total number of patients entering the continuation phase 79% of placebo responders remained well (did not meet relapse criteria) during this phase compared to 93% of antidepressant responders. Although significantly more patients on placebo than on antidepressants relapsed in the continuation phase, 4 out of 5 placebo responders stayed well. The widely held belief that the placebo response in depression is short-lived appears to be based largely on intuition and perhaps wishful thinking.