Clinical Pharmacopsychology: Conceptual Foundations and Emerging Tasks

Abstract

The aim of this critical review was to outline emerging trends and perspectives of clinical pharmacopsychology, an area of clinical psychology that is concerned with the psychological effects of medications. The historical development of clinical pharmacopsychology is outlined, with discussion of its most representative expressions and reference to current challenges of clinical research, with particular reference to clinimetrics. The domains of clinical pharmacopsychology encompass the clinical benefits of psychotropic drugs, the characteristics that predict responsiveness to treatment, the vulnerabilities induced by treatment (side effects, behavioral toxicity, iatrogenic comorbidity), and the interactions between drug treatment and psychological variables. Its aim is to provide a comprehensive assessment of the clinical important changes that are concerned with (a) wanted and expected treatment effects, (b) treatment-induced unwanted side effects, and (c) the patient's own personal experience of a change in terms of well-being and/or quality of life. Clinical pharmacopsychology offers a unifying framework for the understanding of clinical phenomena in medical and psychiatric settings. Research in this area deserves high priority.

An Evolutionary Approach to Clinical Pharmacopsychology

“…Fava, Tomba, and Bech [1] have critically reviewed emerging trends and perspectives in clinical pharmacopsychology. This area of clinical psychology focuses on the psychological effects of medication in clinical populations.…”

Overcoming the Crisis of Clinical Research

“…The journal continues to seek medical papers characterized by the clinical factor and that develop clinical hypotheses. We deal with a broad range of clinical issues, particularly at an interdisciplinary level, related to assessment and treatment, with particular reference to psychotherapy and clinical pharmacopsychology [15] . Our limited space has forced us to develop a research letter section for contributions that we would not have the possibility of publishing as regular articles.…”

Response to “An Evolutionary Approach to Clinical Pharmacopsychology”

“…The universe of clinical pharmacopsychology [1] is the interface between the patient reporting his or her symptoms and the clinician assessing the correspondent signs during the interview to evaluate when treatment is needed or remission has been obtained. In the case of depression we have referred to the brief Hamilton Depression Scale (HAM-D 6 ), covering the symptoms or signs of depressed mood, work and interests, somatic symptoms of tiredness or pains, psychic anxiety, guilt feelings, and psychomotor retardation [2].…”

“…It is the relationship between these 6 HAM-D items that we have described [1], namely, “to what extend each item stands alone on the latent dimension of depression severity.” This is the clinimetric validity of HAM-D 6 . …”

“…In our reference to the pharmacopsychometric triangle [1] we have differentiated the HAM-D 6 assessment for the measure of an antidepressive effect from the appraisal of clinical significant side effects induced by the medication, and used patient-reported quality of life as the ultimate outcome of the pharmacological treatment. The obtained antidepressive effect has to be measured against side effects, which may be subtle and pervasive, and health-related quality of life in clinical pharmacopsychology of major depression.…”