Psychiatric Psychobiological Treatment Versus Exclusive Psychological Treatment in Depressive Disorders

Abstract

Introduction: Scientific information on the antidepressant effectiveness of the varied usual therapeutic interventions is considerable but of poor quality. Objective: To analyse the scientifically well qualified international contributions on the effectiveness of habitual psychobiological psychiatric interventions in depressive disorders. Method: N= 6 structured bibliographic systems have been reviewed in a non-systematic, narrative and synthetic way and N= 75 significant contributions have been selected. Results and discussion: Patients with severe depression are more likely to receive any type of medical attention, but less likely to receive adequate attention. The use of both drugs and psychotherapy is the habitual mixed combined intervention during any ordinary psychiatric treatment. We will call it psychobiological or psychopharmacological intervention. The exclusive psychological intervention without using any medically prescribed drugs, is likely to be less cost/effective. The matter is not only to prioritise but also to adequately combine psychiatric interventions and added psychological interventions when convenient. The intervention on the neurophysiological pathways related with glutamate, the GABAergic, opioidergic, and inflammatory systems as well as on connectome and microbiome are being promoted for future drug antidepressant therapy with encouraging results. Conclusion: The mixed psychiatric option using drugs and psychotherapy, either regulated or not, by the intervening psychiatrist himself or herself is probably the main therapeutic choice for the correctly diagnosed depressive disorders. The psychotherapeutics intervention excluding the psychobiological psychiatric intervention in correctly diagnosed depressions will be insufficient in general. The professional psychological intervention may obviously complement the mixed psychiatric intervention, but can not replace it.

Psychobiology and Treatment of Personality Disorders and Related Prominent Traits

“…Indeed, more than nine out of ten care interventions analysed in numerous recent Cochrane reviews are not supported by high-quality evidence [61]. This includes both the use of specific psychotherapies and medication for personality disorders, difficulties and related traits [62,63].…”