22 - The psychodynamic treatment of mood disorders

Summary

This chapter reviews the evidence base for the use of psychodynamic psychotherapy in mood disorders. Burnard and Maina's studies indicate a specific effect of short-term psychodynamic treatment in improving depressive symptoms when added to antidepressant medications, as compared to supportive psychotherapy. Patients treated with long-term psychodynamic psychotherapy (LTPP) fared better in terms of target symptoms and personality functioning compared to shorter forms of psychotherapy. In the one published study of psychodynamic psychotherapy for post-partum depression (PPD) subjects were randomly assigned to receive routine primary care, nondirective counseling, cognitive behavior therapy (CBT), or psychodynamic therapy and were assessed at 4.5, 9, 18 and 60 months post-partum. The models of psychodynamic psychotherapy used in depression are: brief dynamic therapy (BDT), psychodynamic treatment of depression model of Busch et al., and supportive expressive psychotherapy (SE). Many psychodynamic techniques and interventions can be potentially helpful in the treatment of patients with mood disorders.