The Biological Effects of Psychotherapy in Major Depressive Disorders: A Review of Neuroimaging Studies

Abstract

Major depressive disorder (MDD) is a syndrome, which is quite frequent in the society, can be recurrent and shows symptoms of emotional, cognitive and behavioral disorder. Brain imaging studies support that patients diagnosed with MDD suffer dysfunction in limbic structures such as frontal cortex, amygdala, hippocampus and cingulate cortex and basal ganglions that regulate these functions. Psychotherapy is an effective treatment option for prevention of recurrent depressive attacks as well as for acute treatment of depression. It is thought that psychotherapy shows its effect by focusing on misleading cognitions and emotional information processing processes that lead to rise and persistence of symptoms of depression, which in turn boosts problem solving and coping skills. Neurobiological reflections of clinical recovery achieved by psychotherapy are not yet well known. In this study, it is aimed to review cognitive behavioral psychotherapy (CBT), interpersonal psychotherapy (IPT) and psychodynamic psychotherapy methods used frequently in treatment of MDD, along with functional brain imaging studies performed on treated depressive patients. Studies show that CBT lead to changes in the prefrontal cortex, cingulate cortex and amygdala metabolisms and activities. Activity of the subgenual cingulate cortex, which takes part in the regulation of the limbic activity, seems to play an important role in the response to CBT like in the response to antidepressant treatment. It was found that interpersonal psychotherapy (IPT) ensures recovery of metabolism and blood flow in the prefrontal cortex, cingulate cortex and basal ganglions. It was observed that psychodynamic therapy ensured recovery of abnormal activities in especially the prefrontal cortex and cingulate cortex in MDD, similar to the CBT and IPT. There is need for more long-term, follow-up studies in this area.

Cortical thickness increases with levomilnacipran treatment in a pilot randomised double‐blind placebo‐controlled trial in late‐life depression

“…Antidepressant treatment has the ability to induce neuroplasticity similar to that observed during sensitive periods of early development . Structural neuroplastic changes have been reported in studies of different therapeutic techniques like psychotherapy, electroconvulsive and antidepressant therapies using structural MRI techniques . However, the sensorimotor system is typically not among the major reported effects.…”

Epigenetic and Neural Circuitry Landscape of Psychotherapeutic Interventions

“…IPT is a form of psychotherapy which happens in a stepwise approach to aid the individual in terms of understanding how to adapt to certain life events which may be informing their depressed mood. The main topics addressed include unresolved grief, role conflict, role transitions, and interpersonal deficiencies [ 296 ]. The studies discussed in this section will refer to management of MDD.…”

Neural correlates of psychodynamic and non-psychodynamic therapies in different clinical populations through fMRI: A meta-analysis and systematic review

“…Meta-analytic approaches of psychotherapies can play a fundamental role understanding their neural, together with their psychological effects. This approach uses brain imaging methods to explore potential structural or functional effects of the talking cure on the brain, finding similar dysfunction in limbic structures, amygdala, hippocampus, frontal cortex, cingulate cortex, and basal ganglions (Sözeri-Varma and Karadaǧ, 2012). Abbass et al (2012) described a meta-analysis of brain imaging studies from 11 sources analyzing any form of PDT treatment.…”