Evidence that Psychotherapy really Works.

The review found 40 studies including patients with MDD, obsessive compulsive disorder, posttraumatic stress disorder, and other diagnosis, and other diagnosis. Some studies used structural brain imaging studies, which show brain anatomy, others used functional scans, which demonstrative brain activity.

The researchers analysed brain imaging scans to predict the outcomes of psychotherapy for major depressive and anxiety disorders. Psychiatrists are interested in identifying brain imaging marks of response to psychotherapy –comparable to electrocardiograms and laboratory tests use to decide o treatments for myocardial infarction.

Although no single brain area was consistently associated with response to psychotherapy, the results did identify some “candidate markers” studies suggested that psychotherapy, the might be related to activity in two deep brain areas the amygdala, involved in mood responses and emotional memories and the anterior insula, involved in awareness of the body’s physiologic state, anxiety responses and feelings of disgust.

In MDD studies, patients with higher activity in the amygdala were more likely to respond to psychotherapy. In contrast, in some studies of anxiety disorders lower of anterior insula activity in anxiety disorders and lower activity in MDD.

Other studies linked psychotherapy response to a frontal brain area called the anterior cingulate cortex, which plays a critical role in regulating emotions. Most of the evidence suggested that MDD patients with lower activity in some parts of the ACC were more likely to have outcomes with psychotherapy.

“future studies of psychotherapy response may focus further on these individual regions may focus on pre-treatment functional connectivity between their regions, as affective experience is modulated via reciprocal connections between brain areas such as the ACC and amygdala.

The researchers emphasize the limitations of current evidence on neuro imaging markers of psychotherapy response-the studies were highly variable in terms of their methodology and results. Further studies are needed to assess how the potential neuro imaging markers perform over time, whether they can predict which patients will respond better to medications versus psychotherapy, and how they might be integrated with clinical features in order to improve outcomes for patients with depression and anxiety disorders.

Prepared By Dr.Parameswaran