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Morrissey G, Tsuchiyagaito A, Takahashi T, McMillin J, Aupperle RL, Misaki M, Khalsa SS. Could neurofeedback improve therapist-patient communication? Considering the potential for neuroscience informed examinations of the psychotherapeutic relationship. Neurosci Biobehav Rev 2024; 161:105680. [PMID: 38641091 DOI: 10.1016/j.neubiorev.2024.105680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 03/22/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
Empathic communication between a patient and therapist is an essential component of psychotherapy. However, finding objective neural markers of the quality of the psychotherapeutic relationship have been elusive. Here we conceptualize how a neuroscience-informed approach involving real-time neurofeedback, facilitated via existing functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) technologies, could provide objective information for facilitating therapeutic rapport. We propose several neurofeedback-assisted psychotherapy (NF-AP) approaches that could be studied as a way to optimize the experience of the individual patient and therapist across the spectrum of psychotherapeutic treatment. Finally, we consider how the possible strengths of these approaches are balanced by their current limitations and discuss the future prospects of NF-AP.
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Affiliation(s)
| | - Aki Tsuchiyagaito
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA
| | - Toru Takahashi
- Laureate Institute for Brain Research, Tulsa, OK, USA; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - John McMillin
- Advocate Medical Group, Downers Grove, IL, USA; Department of Psychiatry, University of Oklahoma-Tulsa, Tulsa, OK, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA.
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Caselli I, Ielmini M, Bellini A, Zizolfi D, Callegari C. Efficacy of short-term psychodynamic psychotherapy (STPP) in depressive disorders: A systematic review and meta-analysis. J Affect Disord 2023; 325:169-176. [PMID: 36623570 DOI: 10.1016/j.jad.2022.12.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/20/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Depression is one of the leading diseases globally. It can severely interfere with daily and occupational functioning of people affected. Both pharmacological interventions and psychotherapy are used for adult depression. The aim of the review is to evaluate the efficacy of short-term psychodynamic psychotherapy (STPP) by comparing STPP with different types of interventions. MATERIALS AND METHODS A systematic review with meta-analysis on the efficacy of STPP in depressive disorders was performed. RESULTS Meta-analysis findings confirm the superiority of STPP versus no interventions. The average effect size of depressive symptoms severity at the end of the treatment is -0.91 (95% CI: -1.49 - -0.33) in favor of STPP, while for clinical improvement of depressive symptoms is -0.78 (95% CI: -1.56 - 0.01). Results confirm a clear superiority of STPP to usual treatments unstructured. A mild superiority of efficacy of STPP on support psychotherapy emerged. Comparison of the efficacy of STPP vs cognitive-behavioral psychotherapy (CBT) shows little superior in case of STPP. No substantial differences in efficacy in case of STPP than control interventions emerged. Antidepressant therapy is resulted to be slightly more effective to STPP. DISCUSSION While all the other results confirm current literature, this review shows no superiority of combined treatment than STPP only. LIMITATIONS The review has some limitations such as the lack of moderation analysis and the high heterogenicity of the type of the studies. CONCLUSIONS The results confirm the efficacy of STPP in depressive disorders and endorse the guidelines of National Institute for Health and Clinical Excellence (NICE).
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Affiliation(s)
- Ivano Caselli
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, VA, Italy
| | - Marta Ielmini
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, VA, Italy
| | - Alessandro Bellini
- Department of Medicine and Surgery, Section of Psychiatry, University of Pavia, Pavia, PA, Italy
| | - Daniele Zizolfi
- Viarnetto psychiatric clinic, Pregassona-Lugano, TI, Switzerland
| | - Camilla Callegari
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, VA, Italy.
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Stefana A, D’Imperio D, Dakanalis A, Vieta E, Fusar-Poli P, Youngstrom E. Probing the impact of psychoanalytic therapy for bipolar disorders: A scoping review. INTERNATIONAL FORUM OF PSYCHOANALYSIS 2022. [DOI: 10.1080/0803706x.2022.2097307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Caldiroli A, Capuzzi E, Tringali A, Tagliabue I, Turco M, Fortunato A, Sibilla M, Montana C, Maggioni L, Pellicioli C, Marcatili M, Nava R, Crespi G, Colmegna F, Buoli M, Clerici M. The psychopathological impact of the SARS-CoV-2 epidemic on subjects suffering from different mental disorders: An observational retrospective study. Psychiatry Res 2022; 307:114334. [PMID: 34902818 PMCID: PMC8664498 DOI: 10.1016/j.psychres.2021.114334] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/22/2021] [Accepted: 12/05/2021] [Indexed: 12/16/2022]
Abstract
SARS-CoV-2 infection causes a pulmonary disease (COVID-19) which spread worldwide generating fear, anxiety, depression in the general population as well as among subjects affected by mental disorders. Little is known about which different psychopathological changes the pandemic caused among individuals affected by different psychiatric disorders, which represents the aim of the present study. Specific psychometric scales were administered at three time points: T0 as outbreak of pandemic, T1 as lockdown period, T2 as reopening. Descriptive analyses and linear regression models were performed. A total of 166 outpatients were included. Overall, psychometric scores showed a significant worsening at T1 with a mild improvement at T2. Only psychopathology in schizophrenia (SKZ) patients and obsessive-compulsive (OC) symptoms did not significantly improve at T2. Subjects affected by personality disorders (PDs) resulted to be more compromised in terms of general psychopathology than depressed and anxiety/OC ones, and showed more severe anxiety symptoms than SKZ patients. In conclusion, subjects affected by PDs require specific clinical attention during COVID-19 pandemic. Moreover, the worsening of SKZ and OC symptoms should be strictly monitored by clinicians, as these aspects did not improve with the end of lockdown measures. Further studies on larger samples are needed to confirm our results. ClinicalTrials.gov Identifier: NCT04694482.
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Affiliation(s)
- Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy.
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Agnese Tringali
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Marco Turco
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Andrea Fortunato
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Matteo Sibilla
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Caterina Montana
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Laura Maggioni
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Cristian Pellicioli
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Matteo Marcatili
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Roberto Nava
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Giovanna Crespi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy,Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
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How does borderline personality disorder affect management and treatment response of patients with major depressive disorder? A comprehensive review. J Affect Disord 2021; 281:581-589. [PMID: 33250202 DOI: 10.1016/j.jad.2020.11.111] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Borderline Personality Disorder (BPD) and Major Depressive Disorder (MDD) are two clinical conditions that often co-occur, sharing several neurobiological aspects and clinical features. Depressed patients with BPD frequently report marked dysphoria, anger, emptiness and fear of abandonment. All these elements make the clinical management of MDD in patients with BPD challenging. The purpose of the present manuscript is to summarize the current literature about the effect of BPD on treatment response and management of patients affected by MDD. METHODS A bibliographic research on the main databases (PubMed, Embase, PsycInfo, Isi Web of Knowledge, Medscape, The Cochrane Library) was performed selecting published papers from 1987 until 16th April 2020 and 13 studies were finally included in this review. RESULTS Most of the studies focused on the response to antidepressants, psychotherapeutic treatments or their combinations in patients with both MDD and BPD. In general, the co-occurrence of BPD seems to be associated with a poorer response to MDD treatment. LIMITATIONS The data are not often replicated and most of the studies focus on different treatments, so that it is difficult to compare them. CONCLUSIONS The presence of BPD seems to hamper the achievement of symptom remission in MDD patients, while the combination of selective serotonin reuptake inhibitors (SSRI) and psychotherapy may represent a valid option to treat these patients. Future studies, however, will have to confirm more robustly the findings reported in the present article and to investigate other possible treatment strategies.
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Grossman-Giron A, Becker G, Kivity Y, Shalev S, Tzur Bitan D. Mental pain intensity and tolerance as predictors of psychotherapy process and outcome. J Clin Psychol 2020; 77:1296-1306. [PMID: 33156973 DOI: 10.1002/jclp.23085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/21/2020] [Accepted: 10/25/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND The extensive reliance on symptoms for the study of psychotherapy is often criticized. In this study we examined whether the subjective sense of mental pain predicts psychotherapy process and outcome, above and beyond the effect of symptomatic distress. METHODS Outpatients (n = 53) treated in a psychiatric hospital completed measures of mental pain intensity and tolerance, symptomatic distress, and session climate at pretreatment and posttreatment. Multilevel modeling was utilized to assess the predictive effect of mental pain, while controlling baseline symptomatic distress. RESULTS Patients with high mental pain at baseline showed significant reductions in distress, while patients with low mental pain showed no significant improvement. Moreover, low mental pain and high mental pain tolerance predicted decreases in session smoothness. CONCLUSIONS Mental pain can serve as a predictive marker for psychotherapy process and outcome, and complement the reliance on symptomatic distress in psychotherapy research.
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Affiliation(s)
- Ariella Grossman-Giron
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gideon Becker
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Psychology, College for Law and Business, Ramat Gan, Israel
| | - Yogev Kivity
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
- Department of Psychology, Pennsylvania State University, State College, Pennsylvania, USA
| | - Shani Shalev
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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