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Psicoterapia y farmacoterapia en el tratamiento de la depresión mayor Psychotherapy and Pharmacotherapy in the Treatment of Major Depression  [cached]
Gustavo Figueroa
Revista Chilena de Neuro-Psiquiatría , 2002,
Abstract: Antecedentes. La psiquiatría es la especialidad médica que integra las perspectivas biológicas y psicosociales tanto en el diagnóstico como en el tratamiento. El cuidado médico óptimo requiere evitar los reduccionismos biológicos como psicológicos. Objetivos. Determinar la eficacia relativa de la psicoterapia y la farmacoterapia, aislada o en combinación, para el tratamiento del trastorno depresivo mayor. Método. Revisar y resumir la evidencia cuantitativa de los factores asociados con el tratamiento de la depresión con psicoterapia y farmacoterapia. Resultados. Aunque muchos psiquiatras prefieren el tratamiento combinado, la estrategia combinada claramente es más laboriosa y costosa. Mientras el tratamiento combinado no se demostró significativamente más efectivo que la psicoterapia sola en la depresión menor, se observó una ventaja altamente significativa en las depresiones más severas, recurrentes. Conclusiones. Las recientes guías prácticas de tratamiento para el trastorno depresivo mayor enfatizan la importancia de la severidad de los síntomas al momento de determinar la estrategia a seguir Background. Psychiatry is the medical specialty that integrates the biological and the psychosocial perspectives in both diagnosis and treatment. The provision of optimal clinical care requires avoiding biological or psychological reductionism. Aims. To determine the relative efficacy of psychotherapy and pharmacotherapy, singly or in combination, for the treatment of major depressive disorder. Method. To review and summarize quantitative evidence on factors associated with the treatment of depression concerning psychotherapy and pharmacotherapy. Results. Although most psychiatrists prefer to treat major depressive disorder with both pharmacotherapy and psychotherapy, the combined strategy is clearly the most labor-intensive and expensive approach. Whereas combined therapy was not significantly more effective than psychotherapy alone in milder depressions, a highly significant advantage was observed in more severe, recurrent depressions. Conclusions. Recent practice guidelines for the treatment of major depressive disorder emphasize the importance of symptom severity in determining the strategy to be observed
Psicoterapia interpersonal en el tratamiento de la depresión mayor
Revista chilena de neuro-psiquiatría , 2002, DOI: 10.4067/S0717-92272002000500005
Abstract: introducction. interpersonal psychotherapy (ipt), a time-limited psychotherapy, was developed in the 1970s as a treatment for outpatient adults with major depression. it has been subsequently modified for different age groups and types of mood and non mood disorders and for use as a long-term treatment. it has grown since in its range of research applications and in its clinical accessibility. method. review of recent research and educational developments on ipt. results. ipt has demonstrated efficacy in several randomized controlled trials for acute major depression, for other psychiatric conditions and for long-term treatment of depression. conclusions. by enhancing interpersonal functioning of the depressed patient ipt initiates the reduction of depressive symptomatology and helps solving current life problems as dual goal of therapy. the publication of efficacy data and the appearance of two north american practice guidelines that include ipt among validated treatments for depression have increased the interest among clinicians in many countries
The Effect of Interpersonal Psychotherapy and other Psychodynamic Therapies versus ‘Treatment as Usual’ in Patients with Major Depressive Disorder  [PDF]
Janus Christian Jakobsen,Jane Lindschou Hansen,Erik Simonsen,Christian Gluud
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0019044
Abstract: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment in systematic reviews.
Psicoterapia analítico-existencial de los trastornos depresivos Existential-Analytical psychotherapy in depressive disorders
Alfried L?ngle
Revista Chilena de Neuro-Psiquiatría , 2004,
Abstract: Desde la perspectiva del Análisis Existencial, pueden ser consideradas todas las formas de depresión como una lucha del sujeto por percibir el valor de la propia vida. De acuerdo a esto, la depresión significa una información afectiva de la pérdida de valor y de sentido de la propia vida. Este estado afectivo es el resultado de la concurrencia de causas biológicas, psíquicas y sociales. La significación existencial de los estados depresivos radica en un debilitamiento de la relación del individuo con su propia vida. Esto, a su vez, influye sobre la actitud con respecto a su vida en cuanto a la cuestion de en qué medida es capaz de soportar y de configurar su existencia. Este sufrimiento conlleva reacciones típicas de manejo y de agresión. La psicoterapia analítico-existencial de la depresión apunta al tratamiento de la información emocional trabajando en torno a la actitud de la persona sobre su vida From an existential point of view, all forms of depression can generally be understood as a struggle to feel the value of one’s life. Accordingly, depression conveys the affective information about a loss of value and meaning in one’s life. This emotional state is seen as the result of a tangle of biological, psychical and social causes. The existential impact of depressive moods consists in a weakening of one’s relation to life itself. This, in turn, influences one’s attitude towards life regarding the question of in how far to endure or to shape it. The suffering involved provokes typical coping reactions and patterns of aggression. Existential analytical psychotherapy of depression therefore takes a closer look at the patient’s way of processing emotional information and works on a revision of his or her attitude towards life
The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review
Madelon L J M van Hees, Thomas Rotter, Tim Ellermann, Silvia M A A Evers
BMC Psychiatry , 2013, DOI: 10.1186/1471-244x-13-22
Abstract: Systematic searches of PubMed and PsycINFO studies between January 1970 and August 2012 were performed to identify (C-)RCTs, in which MDD was a primary diagnosis in adult outpatients receiving individual IPT as a monotherapy compared to other forms of psychotherapy and/or pharmacotherapy.1233 patients were included in eight eligible studies, out of which 854 completed treatment in outpatient facilities. IPT combined with nefazodone improved depressive symptoms significantly better than sole nefazodone, while undefined pharmacotherapy combined with clinical management improved symptoms better than sole IPT. IPT or imipramine hydrochloride with clinical management showed a better outcome than placebo with clinical management. Depressive symptoms were reduced more in CBASP (cognitive behavioral analysis system of psychotherapy) patients in comparison with IPT patients, while IPT reduced symptoms better than usual care and wait list condition.The differences between treatment effects are very small and often they are not significant. Psychotherapeutic treatments such as IPT and CBT, and/or pharmacotherapy are recommended as first-line treatments for depressed adult outpatients, without favoring one of them, although the individual preferences of patients should be taken into consideration in choosing a treatment.Major depressive disorder (MDD) is a mental disorder characterized by a depressed mood, diminished interest or pleasure, sleeping problems and tiredness, and negative thoughts [1]. The mean one-year-prevalence of depression in European inhabitants between 18 and 65?years old is 6.9% [2], and 16.2-16.6% of US adults develop a major depressive disorder [3,4]. Furthermore, depression causes a high burden worldwide, taking fourth place in a ranking of leading contributors to the burden of diseases in 2000. In 2020, it is estimated that depression will take second place in the ranking for all ages and sexes [5]. Moreover, depression is the leading cause of years of l
Interpersonal Psychotherapy in the Treatment of Perinatal Depression  [PDF]
Gamze Ergil Altin
Psikiyatride Guncel Yaklasimlar , 2012,
Abstract: Perinatal depression is a psychiatric disorder that is not sufficiently diagnosed and directed to treatment. Its acute and chronic outcomes influence not only the mother but also the infant and the relationship between them. Both pregnancy and the postpartum periods are the times of significant physiological and emotional changes which also influence interpersonal relationships. Interpersonal risk factors like insufficient social support and increased social conflict can have an important impact on the women’s mental and physiological health during this period. Studies have shown that women prefer psychological and social management over drugs during this period. Interpersonal psychotherapy is a time-limited treatment approach, especially focusing on interpersonal difficulties with the goal of reducing depressive symptoms and improving interpersonal functioning. Such distressing factors which can occur during pregnancy and delivery are compatible with the four main problem areas that interpersonal psychotherapy addresses so that the therapist can easily use interpersonal psychotherapy in order to solve such difficulties.
Codependencia y psicoterapia interpersonal.  [cached]
Fernando Mansilla Izquierdo
Revista de la Asociación Espa?ola de Neuropsiquiatría , 2002,
Abstract: La codependencia hace referencia a una actitud obsesiva y compulsiva hacia el control de otras personas y las relaciones, fruto de la propia inseguridad. El abordaje de la codependencia desde la psicoterapia interpersonal se basa en un enfoque pluralista, no doctrinario y empírico, que tiene características específicas. Su peculiaridad se encuentra en sus estrategias, no en sus técnicas. En ella se abordan cuatro áreas: duelo, disputas personales, déficits interpersonales y transiciones de rol.
Codependencia y psicoterapia interpersonal
Mansilla Izquierdo,Fernando;
Revista de la Asociación Espa?ola de Neuropsiquiatría , 2002, DOI: 10.4321/S0211-57352002000100002
Abstract: the codependency refers to an obsessive and compulsive attitude towards the control of other persons and their relations, due to his or her own insecurity. the approach to the codependency through the interpersonal psychotherapy is based on a pluralist, but not doctrinary or empiric view, which presents especific characteristics. its singularity appears not through its tecnics but in its strategies, in which we study for areas: grief, personal arguments, social skills deficits and role transitions.
Universality of interpersonal psychotherapy (IPT) problem areas in Thai depressed patients
Peeraphon Lueboonthavatchai, Nuntika Thavichachart
BMC Psychiatry , 2010, DOI: 10.1186/1471-244x-10-87
Abstract: The Thai Hamilton Rating Scale for Depression (Thai HRSD) and Thai Interpersonal Questionnaire were used to assess 90 depressed and 90 non-depressed subjects in King Chulalongkorn Memorial Hospital, during July 2007 - January 2008. The association between interpersonal problem areas/sociodemographic variables and depressive disorder were analyzed by chi-square test. A multivariable analysis was performed by using logistic regression to identify the remaining factors associated with depressive disorder.Most of the subjects were young to middle-aged females living in Bangkok and the Central Provinces. All four interpersonal problem areas (grief, interpersonal role disputes, role transitions, and interpersonal deficits) were increased in the depressed subjects as compared to the non-depressed subjects, as were the sociodemographic variables (low education, unemployment, low income, and having a physical illness). Logistic regression showed that all interpersonal problem areas still remained problems associated with depression (grief: adjusted OR = 6.01, 95%CI = 1.93 - 18.69, p < 0.01; interpersonal role disputes: adjusted OR = 6.01, 95%CI = 2.18 - 16.52, p < 0.01; role transitions: adjusted OR = 26.30, 95%CI = 7.84 - 88.25, p < 0.01; and interpersonal deficits: adjusted OR = 2.92, 95%CI = 1.12 - 7.60, p < 0.05).All four interpersonal problem areas were applicable to Thai depressed patients.Depressive disorder was one of the leading causes of worldwide disease burden, accounting for 4.46% of total disability-adjusted life-years (DALYs), and for 12.1% of total years lived with disabilities (YLDs) in 2000 [1]. Both major depressive disorder and dysthymic disorder are common depressive disorders, with a lifetime prevalence of about 15% and 3 - 6% respectively [2,3]. In Thailand, the lifetime prevalence of depressive disorder is about 5.7-20.9% [4]. Depressive disorder is believed to be caused by both biological and psychosocial factors.Interpersonal psychotherapy (IPT), de
The Biological Effects of Psychotherapy in Major Depressive Disorders: A Review of Neuroimaging Studies  [PDF]
Gülfizar S?zeri-Varma, Filiz Karada?
Psychology (PSYCH) , 2012, DOI: 10.4236/psych.2012.310129
Abstract: Major depressive disorder (MDD) is a syndrome, which is quite frequent in the society, can be recurrent and shows symptoms of emotional, cognitive and behavioral disorder. Brain imaging studies support that patients diagnosed with MDD suffer dysfunction in limbic structures such as frontal cortex, amygdala, hippocampus and cingulate cortex and basal ganglions that regulate these functions. Psychotherapy is an effective treatment option for prevention of recurrent depressive attacks as well as for acute treatment of depression. It is thought that psychotherapy shows its effect by focusing on misleading cognitions and emotional information processing processes that lead to rise and persistence of symptoms of depression, which in turn boosts problem solving and coping skills. Neurobiological reflections of clinical recovery achieved by psychotherapy are not yet well known. In this study, it is aimed to review cognitive behavioral psychotherapy (CBT), interpersonal psychotherapy (IPT) and psychodynamic psychotherapy methods used frequently in treatment of MDD, along with functional brain imaging studies performed on treated depressive patients. Studies show that CBT lead to changes in the prefrontal cortex, cingulate cor- tex and amygdala metabolisms and activities. Activity of the subgenual cingulate cortex, which takes part in the regulation of the limbic activity, seems to play an important role in the response to CBT like in the response to antidepressant treatment. It was found that interpersonal psychotherapy (IPT) ensures recovery of metabolism and blood flow in the prefrontal cortex, cingulate cortex and basal ganglions. It was observed that psychodynamic therapy ensured recovery of abnormal activities in especially the prefrontal cortex and cingulate cortex in MDD, similar to the CBT and IPT. There is need for more long-term, follow-up studies in this area.
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