🚀 go-pugleaf

Here I am, caught with my references down (again).  I helped organize a
conference for NYNG a few years ago, which included (among other
things) a presentation of neuroimaging data which suggested that 
cognitive therapy (n.b.: I don't we can accept the simplistic equating
of psychotherapy and "understanding"; v. infra) and pharmacotherapy
(with a specific SSRI, I believe) produced similar changes in regional
brain activation in those whose obsessive-compulsive disorder was
alleviated.

Sorry, cannot for the life of me think of the guy's name. From
California, I think...  Anyway, this is not so esoteric; fairly
well-known finding, so you should be able to search it out (via Medline
or whatever).

I cite it just as another example (in addition to the one alluded to
below) that there are as yet poorly explored and even less understood
ways in which different therapies can not only result in similar
outcomes behaviorally but may in some cases do so because of similar
effects on the neuronal substrate of the disorder. 

This could provide a basis for independent (i.e. if monotherapy), or
additive, or synergistic effects of different therapies.

One caveat: I would not want to depend on cognitive therapy or any
other non-physiological therapy for really severe depression.  My
impression (subject to correction, of course) is that studies showing 
comparable results for psychotherapy and pharmacotherapy do so with a
different population: those with mild/moderate depression and/or those
without "true" depression (e.g. with "reactive depression", "adjustment
reaction", etc.).

I almost wrote "pharmacotherapy or ECT"  but realized it was not likely
one would find enought subjects with mild/moderate depression
undergoing ECT...

More re regional differences in activation: we are all hoping for
continued validation of TMS (transcranial magnetic stimulation), which
not only offers the hope of less deleterious side effects than ECT, but
in contrast to ECT's "sledge-hammer" or "shotgun" approach, only
SLIGHTLY refined by the option of unilateral ECT (yes, yes, I know,
seizure will spread to the other hemisphere, but it is applied
unlaterally, and clearly has a unilateral bias in its immediate
aftermath) offers the possibility of zeroing in more precisely on
relevant brain SUB-regions--important both for understanding of the
mechanisms of depression, and (we assume) for better treatments.

F. Frank LeFever, Ph.D.
New York Neuropsychology Group


In <WFvp3.5039$B5.56894@news1.rdc1.bc.home.com> "Sodah"
<sodah1@NO-SPAMhome.com> writes: 
>
>It wouldn't hurt people to do a little research on the description of
>_clinical_ depression, its nature and its modern treatment.  For
example, it
>is fairly well established that clinically depressed patients respond
better
>to a combination of psychotherapy (i.e. "understanding") _plus_
>antidepressant drug therapy, than to either therapy alone.  What you
>fancifully refer to as 'chemical short circuiting', happens to be in
>practice, 'what works'
>
>Sodah
>