Short-Term Psychodynamic Psychotherapy with Mentalization-Based Techniques in Major Depressive Disorder patients: Relationship among alexithymia, reflective functioning, and outcome variables - A Pilot study.

OBJECTIVES: In depressed patients, recent advances have highlighted impairment in mentalizing: identifying and interpreting one's own or other's mental states. Short-Term Psychodynamic Psychotherapy (STPP) has proven to be effective in reducing symptoms and improving relational/functional abilities in these subjects. Therefore, the first aim of our study was to evaluate effectiveness of STPP with Mentalization-Based Techniques (STMBP) on their clinical outcomes and the second, to investigate Reflective Functioning and alexithymia concerning treatment outcomes in depressed subjects. DESIGN: A baseline evaluation of reflective functioning, alexithymia and depression was conducted before an STMBP treatment. Patients were re-tested successively after 40 weeks (T1) and in a follow-up after 1 year at the end of the treatment (T2). METHODS: A total of 24 patients principally diagnosed with Major Depressive Disorder (MDD) underwent a STMBP conducted by two expert therapists. Global Assessment Functioning (GAF), Toronto Alexithymia Scale-20 (TAS-20) and Hamilton Depression Rating Scale (HAM-D) data were collected at the baseline (T0) by two clinical therapists, along with RF scores rated by two trained raters. HAM-D, TAS-20 and GAF follow-ups were conducted at the end of the treatment after 40 weeks (T1) and after 1-year follow-up (T2). RESULTS: Results highlighted an improvement of both HAM-D and TAS-20 scores in our sample. Moreover, a negative correlation between RF and TAS-20 was found. Both HAM-D and RF at T0 influenced depressive outcomes at the end of the treatment. CONCLUSIONS: Results confirmed the effectiveness of STMBP in MDD, suggesting also an inverse association between RF and alexithymia. PRACTITIONER POINTS: Our study demonstrates how STMBP could be effective in MDD even after 40 sessions, maintaining its effect in a 1-year follow-up. STMBP improves subjective capability of reflecting on the mental states of oneself and others. Our intervention allows patients to orientate thoughts from inside to outside, reducing negative beliefs also in absence of a pharmacological therapy (during the follow-up).

[Efficacy of short-term psychodynamic psychotherapy vs treatment as usual in a sample of patients with anxiety and depressive disorders]. / Efficacia della psicoterapia psicodinamica breve vs trattamento psichiatrico di routine in un campione di pazienti con disturbi d'ansia e dell'umore.

INTRODUCTION: The aim of this study is to evaluate the clinical efficacy of short-term psychodynamic psychotherapy (STPP) in comparison with treatment as usual (TAU) in treatment of patients suffering from anxiety and depressive disorders. METHODS: Sixty patients were recruited from the Psychotherapy Service, University of Milan, Department of Psychiatry, at Milan's IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico with the diagnosis of depressive or anxiety disorders according to DSM-IV-TR criteria. These subjects were randomly assigned in a 1:1 ratio to an intervention group (STPP) or control group (TAU) for 12 months (T1). Each patient was clinically evaluated at the moment of recruitment (T0) and after 12 months using a battery composed of these scales: Clinical Global Impression Scale (CGI), Symptom Checklist-90-Revised (SCL-90-R), Inventory of Interpersonal Problems (IIP). RESULTS: Statistical analysis highlighted significant improvements (p<0.05) for the group treated with STPP in every clinical scale. Instead control group revealed significant changes (p<0.05) only for SCL-90 scale scores. We noticed a clinical improvement in both groups without particular differences, but the IIP scores went through a significant higher enhancement only in STPP group. CONCLUSIONS: Our results suggest that STPP is so effective as TAU in treatment of anxiety and depressive disorders. Moreover STPP leads to a better recover of relational functioning.

Short-term psychodynamic psychotherapy versus treatment as usual for depressive and anxiety disorders: a randomized clinical trial of efficacy.

This randomized clinical trial aimed to evaluate the clinical efficacy of short-term psychodynamic psychotherapy (STPP) in the treatment of patients suffering from anxiety or depressive disorders, as compared with a control case sample composed of patients undergoing treatment as usual (TAU). Sixty patients with depressive or anxiety disorders according to DSM IV-TR were randomly assigned in a 1:1 ratio to an intervention group (STPP) or control group for 12 months (T1). Primary outcome measures were the Symptom Checklist 90-Revised (SCL-90-R), the Inventory of Interpersonal Problems (IIP), and the Clinical Global Impression Improvement Scale. Intention to treat analysis revealed that patients who received STPP showed significantly more improvements in comparison with those who were in the TAU group on Clinical Global Impression Improvement Scale and IIP measures. This study offers evidence that STPP is an effective treatment for patients with anxiety or depressive disorders, and it could be more effective than TAU in improving interpersonal problems as measured by IIP.