Intractable depression successfully treated with a combination of autogenic training and high-dose antidepressant in department of otorhinolaryngology: a case report

Abstract

IntroductionPatients suffering from ear discomfort are commonly encountered in the department of otolaryngology. If various clinical examinations do not reveal any objective findings, then the patients are referred to the department of internal medicine or psychiatry. Psychotherapy is recommended in some cases. This paper describes the successful administration of autogenic training in a patient suffering from ear discomfort due to major depression.Case presentationWe present a case of intractable depression that was successfully treated with a combination of psychotherapy, administered by a clinical psychologist, and high-dose antidepressant. The patient was a 36-year-old female with hearing discomfort in her left ear. In 2003, she experienced insomnia and an appetite loss, and her condition was diagnosed as major depression along with an avoidant personality disorder. Her depression has not been improved with antidepressant treatment for 3 years in department of psychosomatic medicine. She was referred to our department because of ear discomfort in her left ear. There was no abnormality in her physical examinations. She wanted to be treated in department of otorhinolaryngology. We increased the dose of fluvoxamine maleate up to 200 mg/day, and introduced cognitive therapy and autogenic training by a clinical psychologist. Eventually, her depressive state as well as the hearing complaint was markedly alleviated.ConclusionAutogenic training can be a viable and acceptable treatment option for patients who fail to respond to other therapies. This case emphasizes the importance of autogenic training as a method to control physical symptom of depression.

Autogenic Training in Mental Disorders: What Can We Expect?

“…However, they were not as effective as psychological (mainly cognitive behavior) treatment in reducing self-rated depressive symptoms [27]. Depression symptoms in the AT group improved significantly [26,28] more than in the delayed-treatment control group, but significantly less than in the psychotherapy group [28]. The psychopathological status improved significantly in 23 multimorbid, gerontopsychiatric patients during the 7-week supportive AT course (brief psychiatric rating scale p < 0.001; geriatric depression scale p < 0.001) [29].…”