New Issues in the Treatment of Mood Disorders

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New areas in the treatment of mood disorders are explored in this session from the 153rd annual meeting of the American Psychiatric Association in Chicago, Illinois. Among the topics discussed were the use of combination therapy to reduce hospital stay, comparison of pharmacologic options for treatment, and the relation between fish consumption and depression in the general population.

Combination Treatment of Depression

Antonio Andreoli, MD,[1] of the department of psychiatry at the Cantonal Hospital in Geneva, Switzerland, presented the findings of his study on the effectiveness of combined psychodynamic psychotherapy and pharmacotherapy vs pharmacotherapy alone in the outpatient treatment of major depression.

The study looked at 74 consecutive patients referred to an outpatient clinic for acute treatment of severe depression. Most of these patient were young women. Any patient with psychotic features was excluded. The method used to classify the depression was not specified. Thirty-six patients were randomized to a clomipramine and psychotherapy arm, and 39 patients were randomized to the clomipramine with nonspecific care arm.

Psychotherapy was provided by nurses, who were experienced in doing psychodynamic psychotherapy. They received an additional 6 months of training focusing on empathy, insight, and enduring patterns of coping. The nurses received regular supervision from a psychoanalyst on their ongoing therapy cases. The purpose was to provide additional care that went beyond the forming of individual alliances with the patient and focused on working out specific problems. Transference issues were looked at only if a problem developed.