Estudo de fatores psicodinâmicos e neurobiológicos em psicoterapia psicodinâmica

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

2011

RESUMO

Introduction: Despite the extensive use of psychodynamic psychotherapy for a variety of mental disorders, the mechanisms of action that contribute to its effectiveness remain to be elucidated. In this context, it can be interesting to investigate both psychodynamic and neurobiological factors that may be involved in the psychotherapeutic process. We can study these aspects separately, since it s not disregarded the fact that they are inseparable in practice. The brain derived neurotrophic factor (BDNF) have been implicated in memory mechanisms and synaptic plasticity, processes possibly involved in the changes generated by psychotherapy. Method: This work refers to preliminary results of a naturalistic longitudinal study, in which 66 patients initiated Psychodynamic Psychotherapy and some of them were already evaluated in 3 different moments: before starting (time 0), after about 6 months (time 1), and at about 1 year (time 2). We performed a cross-sectional study with patients before starting psychotherapy, focusing the study of object relations (OR) and its relations with other important parameters to this treatment. We also made a preliminary comparison between patients in those three moments of the treatment, regarding BDNF serum levels. Results: We found interesting correlations of OR with defensive style, symptom severity and quality of life, as well as different patterns of OR between different diagnoses. By using Generalized Structural Equation Modeling to compare the three groups, we found a significant difference in serum BDNF levels between the three times of treatment (p=0.02). We also found different patterns of variation in BDNF levels in different groups of diagnoses. Groups without a diagnosis of Axis I and with Anxiety Disorders, had a reduction in serum BDNF levels during treatment, while patients with mood disorder showed an increase. Discussion: These results may, by one hand, contribute to understanding how the inner world of patients, accessed by OR, is involved in the therapeutic process. By the other hand, our finding corroborates with the hypothesis that psychotherapy can have an effect on mechanisms of neuroplasticity. The difference in the pattern of variation between the diagnoses to suggest that psychotherapy may act through more than a neurobiological pathway, possibly according to the needs of each patient. We can venture an attempt to integrate these two results in some aspects of them. However, it is important to consider the fact that we are dealing with a heterogeneous population in terms of diagnoses and medication use. Although preliminary, these results may be important in generating hypotheses for further studies.

ASSUNTO(S)

psicoterapia mecanismos de defesa manifestações neurológicas fator neurotrófico derivado do encéfalo transtorno obsessivo-compulsivo

ACESSO AO ARTIGO

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