Psychodynamic Psychotherapy and Clomipramine in the Treatment of Major Depression

Abstract

Provision of supplemental psychodynamic psychotherapy to patients with major depression who are receiving antidepressant medication is cost-effective.

Disappointed Love and Suicide: A Randomized Controlled Trial of “Abandonment Psychotherapy” Among Borderline Patients

“…Intensive community treatment as usual (TAU) was conducted within a psychiatric crisis intervention unit (Burnand et al, 2002) and included as many nurse visits as required for two weeks and biweekly thereafter, weekly clinical review and medication adjustment from a psychiatrist, group therapy, social worker support, and as much day care, night hospitalization, and family intervention as needed to deal with suicidal relapse. Doctors and nurses were well experienced in the treatment of borderline patients.…”

“…The centers also provided emergency response 24 hours a day, 7 days a week. Clinical supervision was widely available by attendant psychiatrists, clinical psychologists, and senior nurses who were well trained in psychodynamic psychotherapy and/or cognitive psychotherapy (Burnand et al, 2002;McQuillan et al, 2005). After one month, patients were discharged and referred to ambulatory treatment with a psychiatrist who was trained in psychotherapy.…”

“…Two psychiatrists and three clinical psychologists, ranging in age from 35 to 61, who had all completed structured training in psychodynamic psychotherapy and who had considerable psychotherapy experience, delivered AP-P. AP-N was delivered by eight nurses aged 31-54 who had extensive crisis intervention experience with depressed and borderline patients (Berrino et al, 2011;Burnand et al, 2002). The nurses had been previously rated from good to very good on an instrument assessing quality of therapeutic skill with borderline patients (Andreoli et al, 2000).…”

“…Finally, we compared the efficacy of abandonment psychotherapy delivered by boarded psychotherapists versus experienced nurses without structured psychotherapy training. In previous articles, we showed that simple psychotherapeutic interventions delivered by well-trained, carefully supervised nurses were cost-effective among depressed patients with severe personality psychopathology (Burnand, Andreoli, Kolatte, Venturini, & Rosset, 2002) and among patients referred to the ER with BPD and deliberate self-harm (Berrino et al, 2011). In times of reduced funding, such interventions are less expensive and may provide a valuable alternative to psychotherapy delivered by boarded psychotherapists.…”

Psychoanalytic and Psychodynamic Therapies for Depression: The Evidence Base

“…Augmenting antidepressants with STPP (v. anti depressants alone) Burnand et al (2002) investi gated the question of combined therapy the other way around: augmenting antidepressant medica tion with a 10session form of STPP, administered in this case by welltrained nurses, to enhance the outcomes of patients in an acutephase major depressive episode. The patients had been referred to an outpatient psychiatric service, and had moderate to severe degrees of depression; half had had previous episodes; half had some form of personality disorder.…”