Intranasal adminsitration of oxytocin in postnatal depression: implications for psychodynamic psychotherapy from a randomized double-blind pilot study

Abstract

Oxytocin is a neuropeptide that is active in the central nervous system and is generally considered to be involved in prosocial behaviors and feelings. In light of its documented positive effect on maternal behavior, we designed a study to ascertain whether oxytocin exerts any therapeutic effects on depressive symptoms in women affected by maternal postnatal depression. A group of 16 mothers were recruited in a randomized double-blind study: the women agreed to take part in a brief course of psychoanalytic psychotherapy (12 sessions, once a week) while also being administered, during the 12-weeks period, a daily dose of intranasal oxytocin (or a placebo). The pre-treatment evaluation also included a personality assessment of the major primary-process emotional command systems described by Panksepp () and a semi-quantitative assessment by the therapist of the mother’s depressive symptoms and of her personality. No significant effect on depressive symptomatology was found following the administration of oxytocin (as compared to a placebo) during the period of psychotherapy. Nevertheless, a personality trait evaluation of the mothers, conducted in our overall sample group, showed a decrease in the narcissistic trait only within the group who took oxytocin. The depressive (dysphoric) trait was in fact significantly affected by psychotherapy (this effect was only present in the placebo group so it may reflect a positive placebo effect enhancing the favorable influence of psychotherapy on depressive symptoms) but not in the presence of oxytocin. Therefore, the neuropeptide would appear to play some role in the modulation of cerebral functions involved in the self-centered (narcissistic) dimension of the suffering that can occur with postnatal depression. Based on these results, there was support for our hypothesis that what is generally defined as postnatal depression may include disturbances of narcissistic affective balance, and oxytocin supplementation can counteract that type of affective disturbance. The resulting improvements in well-being, reflected in better self-centering in post-partuent mothers, may in turn facilitate better interpersonal acceptance of (and interactions with) the child and thereby, improved recognition of the child’s needs.

The oxytocinergic system in PTSD following traumatic childbirth: endogenous and exogenous oxytocin in the peripartum period

“…The latter finding is in line with previous links suggested between hormonal status and PTSD risk in women (Garcia et al 2018). No additional effects of daily OT during the treatment period of 12 weeks on depression or on attachment-like emotional traits in postpartum depressed mothers were found in a small trial of Clarici et al (2015). Only self-centeredness during treatment was significantly lower in the OT group compared with placebo (Clarici et al 2015).…”

The Use of Lausanne Trilogue Play in Three Cases of Gastroschisis Diagnosed during Pregnancy

“…Indeed, only a few months after birth, these parents have the chance to interact with a lively newborn that they can see and touch. This aspect, together with the child’s positive reaction to surgery and medical treatment, give the parents hope, mitigating their fears of death and illness (Clarici et al, 2015; Tripani et al, 2015). …”

“…Empirical research has shown that parents’ intra-psychic dynamics during the perinatal period have an impact on the development of representations and interactive capabilities in the months following birth (Siddiqui and Hägglöf, 2000). Numerous studies in the field highlighted the importance of triadic family interaction as one of the most relevant factors in structuring the baby’s psychosocial development (Parke and Buriel, 1998) in various salient aspects, such as attachment (Erdman and Caffery, 2003), school adjustment (McHale and Rasmussen, 1998), psychopathological development (Jacobvitz et al, 2004; Clarici et al, 2015; Gatta et al, 2017), and theory of mind (Favez et al, 2012). However, studies on the influence of defect diagnosis on parental capacity in the time span between pregnancy and postpartum period are still very scarce (Skari et al, 2006; Giuliani et al, 2014).…”

Concept of Suicide: Neurophysiological/Genetic Theories and Possible Oxytocin Relevance

“…As we mentioned at different other occasions [45], within the last few years there was an increase in the number of research groups and general interest for better understanding of the possible beneficial effects exerted especially by intranasal oxytocin on the main neuropsychiatric diseases, with a focus on schizophrenia [54], depression [55], frontotemporal dementia [56], autism [57], or anxiety-related behavior [58].…”