Depression is refractory to treatment after psychiatric psychotherapy.

A recent study published in psychotherapy Intensive short-term psychotherapy (ISTDP) has been shown to be an effective treatment for treatment-resistant depression (TRD). Studies have found that ISTDP has positive results. This is especially true in patients who do not get relief from their depressive symptoms while taking antidepressants.

During a randomized controlled trial (RCT), researchers found that ISTDP significantly reduced negative affect and emotional suppression. Both of which are linked to depression. Additionally, participants continued to benefit from the treatment even three months after the trial ended.

The results show that the effects of ISTDP for TRDs are not limited to depression symptoms. But the negative effects are reduced more broadly. ISTDP can reduce emotional repression. This is consistent with the assumed mechanism of action. The author writes Together, this indicates that ISTDP may be a promising treatment for TRD. This is highly relevant because TRD is a prevalent disease that is associated with significant personal and social costs. Other psychotherapies have not been shown to be effective compared to treatment as usual.

The study was conducted by Rasoul Heshmati from the University of Tabriz together with Frederik J. Wienicke and Ellen Driessen from the Radboud University Institute of Behavioral Sciences.

Psychiatric psychotherapy continues to show significant effectiveness in treating psychological distress or psychiatric disorders. As the biomedical treatment model is called A number of randomized control trials have demonstrated the effectiveness of this approach in reducing symptoms of depression and bipolar disorder. Anxiety and panic post-traumatic stress, psychological problems, and so-called personality disorders. Meta-analytic studies have also confirmed the effectiveness of these treatments.

Just like any other treatment method. There are many treatment models available in psychotherapy, including ISTDP. This model is characterized by its confrontational and emotion-focused nature. (rather than focusing on symptoms) whereby therapeutic interventions promote the experience and processing of unconscious emotions. To reduce suffering and change behavior Although previous research has shown the effectiveness of this approach, This includes depression that is resistant to treatment. There is still limited research on reducing negative affect and emotional suppression. which is the theoretical mechanism of change

The researchers conducted a randomized control trial to test their theoretical hypothesis. The trial involved patients who had never experienced a reduction in their depressive symptoms after psychiatric treatment. The aim of the trial is to evaluate the effectiveness of ISTDP in reducing symptoms in this group. as well as reducing negative affect and emotional suppression.

In 2020, the team enrolled adult participants between the ages of 18 and 60 and who had completed at least a high school degree. These participants met criteria for major depressive disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is assessed through Mini-International Neuropsychiatric Interview-Plus

To participate in this study A person must meet criteria for treatment-resistant depression. This means they did not respond to at least one open trial of antidepressants. After screening Eighty-six participants were recruited, of whom 43 were assigned to the experimental group. (who will receive treatment) and 43 people in the control group (which will not be treated)

Two experienced psychotherapists specializing in Intensive Short-Term Dynamic Psychotherapy (ISTDP) provide a total of 20 sessions per week. Twice a week for ten weeks One therapist treated 22 participants and another treated 21 participants. The researcher collected sociodemographic information on the participants, such as age, gender, and marital status. Education level Employment status and socioeconomic status. Additionally, the Weinberger Adjustment Inventory (WAI) and the Positive and Negative Affect Schedule (PANAS) were used to assess participants’ depressive symptoms. negative effects and repressed emotions at baseline, after treatment, and three months after treatment.

Initially, there were no significant differences between the control and experimental groups, however, participants undergoing ISTDP treatment were found to have depressive symptoms. emotional repression and significantly lower levels of negative impacts compared to the control group The effect of treatment is large in all areas. both immediately after treatment and 3 months after treatment When compared to initial baseline, effect sizes were also significant when comparing changes in depression and emotional suppression between post-treatment and 3-month follow-up.

In terms of negative emotions The effect was large both immediately after treatment and three months after treatment, however, the effect size was midway between these two time points. These findings indicate that ISTDP has a long-term positive impact on participants. Even after treatment has ended

These results continue to support evidence of the effectiveness of psychodynamic psychotherapy. and emphasize the importance and relevance of treatment models that do not focus on symptoms. Many of these have been proven ineffective in treating what’s called treatment-resistant depression.

It also presents evidence that contradicts the concept of treatment resistance. It is assumed that the patient cannot receive relief from the treatment. Instead of recognizing the limitations and problems of psychiatric treatment,

with emotion-focused treatment that involves a deep connection between participant and therapist. and attempt to address some of the underlying problems that lead to suffering. (as opposed to simply reducing symptoms) Many patients experience no or decreased well-being. Mental distress through medication can be cured or relieved from suffering.


Heshmati, R., Wienicke, FJ, & Driessen, E. (2023) Effects of short-term intensive dynamic psychotherapy on depressive symptoms. negative effects and emotional suppression in depression resistant to single treatment: a randomized controlled trial. psychotherapy. Advanced online publications (link)

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