Combined psychotherapeutic and psychopharmacological treatment for depression and anxiety. Are psychodynamic psychotherapies and psychoanalysis effective? Historical and neurobiological foundations. Clinical results

The author presents a review of the literature on the combined treatment psychotherapy and medication - for depression and anxiety disorders utilising the data published in PUBMED, and other specialised journals in pharmacology, psychopharmacology and psychiatry. Nowadays, a number of mental health approaches still consider the cause of mental disorders either in genetic and biological alterations, or in socio-cultural conflicts, regardless of the possible combinations of both genetic-biological and socio-cultural variables. These radical choices produce extreme opinions - on the one hand one has biology and medical prescriptions, on the other social context and interpretations, such standpoints hinder cross-disciplinary approaches. In addition, the developments in psychodynamic psychotherapy and psychoanalysis have been primarily based on cases studies, and only a few on evidence-based trials and comparative analyses of different therapeutic procedures. Yet, over the years, a number of authors have attempted to combine biological and socio-cultural fields of study, without trying to invalidate one of the two. Today, our knowledge of the role played by etiopathogenetic and neurobiological factors in psychiatric disorders highlights the gene-environment interaction and trims down the theoretical dichotomies. Discoveries in neurosciences are revealing the mechanisms underlying therapeutic processes. Furthermore, evidenced-based studies emphasize the importance of integrated care, combining psychotherapy and medication, in particular in depression and anxiety disorders. So far, most clinical trials have made use of cognitive behavioural therapy (CBT) and of interpersonal psychotherapy; however, there is currently a growing number of studies utilising psychodynamic psychotherapy and psychoanalysis.

Keywords: Combined treatment, pharmacotherapy and psychotherapy, depression, anxiety.

Sebastian A. Alvano, Trattamento combinato psicoterapeutico e psicofarmacologico nei disturbi depressivi e d’ansia. Sono efficaci le psicoterapie psicodinamiche e la psicoanalisi? Fondamenti storici e neurobiologici. Risultati clinici in "RIVISTA SPERIMENTALE DI FRENIATRIA" 1/2012, pp 47-83, DOI: 10.3280/RSF2012-001004