Neural Predictors of Successful Brief Psychodynamic Psychotherapy for Persistent Depression

Background: Psychodynamic psychotherapy has been used to treat depression for more than a century. However, not all patients respond equally well, and there are few reliable predictors of treatment outcome. Methods: We used resting 18 F-fluorodeoxyglucose positron emission tomography ( 18 FDG-PET) s...

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Bibliographic Details
Published in:Psychotherapy and psychosomatics 2014-01, Vol.83 (6), p.364-370
Main Authors: Roffman, Joshua L., Witte, Janet M., Tanner, Alexandra S., Ghaznavi, Sharmin, Abernethy, Robert S., Crain, Laura D., Giulino, Patricia U., Lable, Ira, Levy, Raymond A., Dougherty, Darin D., Evans, Karleyton C., Fava, Maurizio
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Biological and medical sciences
Brain - physiopathology
Clinical Note
Depression
Depressive Disorder, Major - physiopathology
Depressive Disorder, Major - therapy
Female
Humans
Individual psychotherapy
Male
Medical sciences
Miscellaneous
Mood disorders
Neuroimaging
Positron-Emission Tomography
Predictive Value of Tests
Psychiatric Status Rating Scales
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychotherapies. Psychological and clinical counseling
Psychotherapy, Brief
Treatment Outcome
Treatments
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Summary:Background: Psychodynamic psychotherapy has been used to treat depression for more than a century. However, not all patients respond equally well, and there are few reliable predictors of treatment outcome. Methods: We used resting 18 F-fluorodeoxyglucose positron emission tomography ( 18 FDG-PET) scans immediately before and after a structured, open trial of brief psychodynamic psychotherapy (n = 16) in conjunction with therapy process ratings and clinical outcome measures to identify neural correlates of treatment response. Results: Pretreatment glucose metabolism within the right posterior insula correlated with depression severity. Reductions in depression scores correlated with a pre- to posttreatment reduction in right insular metabolism, which in turn correlated with higher objective measures of patient insight obtained from videotaped therapy sessions. Pretreatment metabolism in the right precuneus was significantly higher in patients who completed treatment and correlated with psychological mindedness. Conclusions: Resting brain metabolism predicted both clinical course and relevant psychotherapeutic process during short-term psychodynamic psychotherapy for depression.
ISSN:0033-3190
1423-0348
DOI:10.1159/000364906