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Progress in the psychotherapy of mood disorders: studies from the Western Psychiatric Institute and Clinic

Published online by Cambridge University Press:  11 October 2011

Ellen Frank*
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA
Danielle Novick
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA
*
Indirizzo per la corrispondenza: Dr. E. Frank, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213 (USA). Fax: +1-412-624-5734 E-mail: franke@msx. upmc. edu

Summary

— During the last three decades, we have witnessed dramatic improvements in both the psychosocial and pharmacological treatments of affective disorders. Administered in concert with the new medications advances in pharmacology have produced, disorder-specific psychosocial treatments have further improved the prognosis and course of bipolar and unipolar disorder. Methods — We review our research on unipolar and bipolar disorder and their treatment, in particular interpersonal psychotherapy (IPT) and modifications thereof. Results — We provide empirical evidence that IPT is an efficacious acute and maintenance treatment for affective disorders. Our cumulative research and clinical experience suggest that interpersonal relations and circadian and social rhythms influence affective illnesses and that psychotherapy may aid in normalizing problems in these areas for patients with affective illnesses. Conclusions — Despite the excitement generated by the recent progress in research on mental disorders and their treatment, we are yet to fulfill the promise that the explosion of knowledge about targeted pharmacotherapies or psychotherapies would seem to offer. To move our field forward, we must continue to apply scientific rigor and thought to understanding the suitability of current nomenclatures, the impact of comorbid psychiatric and medical illnesses and symptoms on the manifestation and treatment of affective disorders, and the practicality of widespread utilization of new treatments.

Riassunto

— Durante gli ultimi tre decenni abbiamo assistito a significativi miglioramenti sia nei trattamenti psicosociali, sia in quelli farmacologici dei disturbi affettivi.Insieme ai progressi che i nuovi trattamenti farmacologici hanno prodotto, il trattamento psicosociale per la cura specifica del singolo disturbo ha ulteriormente migliorato la prognosi ed il decorso del disturbo bipolare e unipolare. Metodi — Rassegna delle nostre ricerche sul disturbo unipolare e bipolare e sul loro trattamento, in particolare la psicoterapia interpersonale (IPT) e le sue modificazioni. Risultati — Si fornisce la dimostrazione empirica che l'IPT à un trattamento per i disturbi affettivi efficace per la fase acuta e per il mantenimento. La nostra ricerca cumulativa e l'esperienza clinica suggeriscono che le relazioni interpersonali ed i ritmi circadiani e sociali influenzano i disturbi affettivi e che la psicoterapia pud aiutare a normalizzare i problemi in questi settori per i pazienti con disturbi affettivi. Conclusioni — Nonostante l'entusiasmo generato dai recenti progressi nella ricerca sui disturbi mentali e sul loro trattamento, dobbiamo ancora soddisfare l'impegno che l'enorme sviluppo delle conoscenze sulle farmacoterapie mirate e sulle psicoterapie sembrerebbero offrire. Per fare ulteriori progressi, dobbiamo continuare ad applicare rigore scientifico e riflessione per capire l'adattabilita delle attuali nomenclature, l'impatto delle malattie psichiche e mediche in comorbidità sulla manifestazione e sul trattamento dei disturbi affettivi e la praticabilita di un'ampia utilizzazione dei nuovi trattamenti.

Type
Invited Papers
Copyright
Copyright © Cambridge University Press 2001

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