Article

An outcome of psychodynamic psychotherapy: A case study of the change in serotonin transporter binding and the activation of the dream screen

Adult Psychiatry Division, Department of Psychiatry, Kuopio University Hospital, Finland.
American journal of psychotherapy 02/2005; 59(1):61-73.
Source: PubMed

ABSTRACT We explored the outcome of psychodynamic psychotherapy of a female patient with major depression using clinical evaluation and serotonin transporter (SERT) binding assessed with [123I]nor-beta-CIT SPECT. The psychotherapy process was analyzed with special emphasis on the change that was recognized in the dreaming process. The activation of the dream screen in transference seemed to form a turning point during the psychotherapy. Normalization of SERT binding at the midbrain level was found on 12-month follow-up. Major alleviation of depressive symptoms assessed by rating scales was evident only six months after SERT normalization.

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    • "While these originally psychodynamic concepts are currently investigated in the neuroscientific context, the neural basis of core elements of psychoanalysis and psychodynamic psychotherapy has not been elucidated yet. Though neurobiological changes in some single cases undergoing psychodynamic psychotherapy have been reported (Viinamäki et al., 1998; Overbeck et al., 2004; Saarinen et al., 2005; Lai et al., 2007; Lehto et al., 2008; Kessler et al., 2011a, 2012), systematic and well-controlled brain imaging studies of the neural effects of psychodynamic psychotherapy are still lacking. "
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    • "The team members were not involved in the development of the questionnaires. The psychotherapy consisted of approximately 80 sessions per year, held twice a week, in the outpatient clinic of the Department of Psychiatry of Kuopio University Hospital (Saarinen et al., 2005; Tolmunen et al., 2004). The patients' motivation and aptitude for long-term psychodynamic psychotherapy without medication was assessed by an evaluation group consisting of a psychiatrist and a psychologist and/or a specially trained nurse. "
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    • "Furthermore, three case studies (Saarinen et al., 2005; Tolmunen et al., 2004; Viinamaki, Kuikka, Tiihonen, & Lehtonen, 1998) and a case series (Lehto et al., 2008) reported an increase in serotonin transporter densities in response to 1 year of psychodynamic psychotherapy treatment. These studies followed up a patient with depression and borderline personality disorder (Viinamaki et al., 1998), a patient with depression (Saarinen et al., 2005), a patient with mixed mania (Tolmunen et al., 2004), and a sample of eight patients classified as having atypical depression (Lehto et al., 2008). Such results indicate that psychopharmacotherapy and psychotherapy both yield important and similar changes in neural activity, although likely through different mechanisms (Beutel et al., 2003). "
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