150 research outputs found
Revisiting ‘What works for whom?’: A qualitative framework for evaluating clinical effectiveness in child psychotherapy
Evolution in the Brain, Evolution in the Mind: The Hierarchical Brain and the Interface between Psychoanalysis and Neuroscience
This article first aims to demonstrate the different ways the work of the English neurologist John Hughlings Jackson influenced Freud. It argues that these can be summarized in six points. It is further argued that the framework proposed by Jackson continued to be pursued by twentieth-century neuroscientists such as Papez, MacLean and Panksepp in terms of tripartite hierarchical evolutionary models. Finally, the account presented here aims to shed light on the analogies encountered by psychodynamically oriented neuroscientists, between contemporary accounts of the anatomy and physiology of the nervous system on the one hand, and Freudian models of the mind on the other. These parallels, I will suggest, are not coincidental. They have a historical underpinning, as both accounts most likely originate from a common source: John Hughlings Jackson's tripartite evolutionary hierarchical view of the brain
Psicoterapia psicodinâmica e tratamento biológico com fluoxetina: comparação de resposta cognitiva em pacientes deprimidos
Tavistock Adult Depression Study (TADS): a randomised controlled trial of psychoanalytic psychotherapy for treatment-resistant/treatment-refractory forms of depression
ABSTRACT: BACKGROUND: Long-term forms of depression represent a significant mental health problem for which there is a lack of effective evidence-based treatment. This study aims to produce findings about the effectiveness of psychoanalytic psychotherapy in patients with treatment-resistant/treatment-refractory depression and to deepen the understanding of this complex form of depression. METHODS: INDEX GROUP: Patients with treatment resistant/treatment refractory depression. DEFINITION & INCLUSION CRITERIA: Current major depressive disorder, 2 years history of depression, a minimum of two failed treatment attempts, [greater than or equal to]14 on the HRSD or [greater than or equal to]21 on the BDI, plus complex personality and/or psycho-social difficulties. EXCLUSION CRITERIA: Moderate or severe learning disability, psychotic illness, bipolar disorder, substance dependency or receipt of test intervention in the previous two years. DESIGN: Pragmatic, randomised controlled trial with qualitative and clinical components. TEST INTERVENTION: 18 months of weekly psychoanalytic psychotherapy, manualised and fidelity-assessed using the Psychotherapy Process Q-Sort. CONTROL CONDITION: Treatment as usual, managed by the referring practitioner. RECRUITMENT: GP referrals from primary care. RCT MAIN OUTCOME: HRSD (with [less than or equal to]14 as remission). SECONDARY OUTCOMES: depression severity (BDI-II), degree of co-morbid disorders Axis-I and Axis-II (SCID-I and SCID-II-PQ), quality of life and functioning (GAF, CORE, Q-les-Q), object relations (PROQ2a), Cost-effectiveness analysis (CSRI and GP medical records). FOLLOW-UP: 2 years. Plus: a). Qualitative study of participants' and therapists' problem formulation, experience of treatment and of participation in trial. (b) Narrative data from semi-structured pre/post psychodynamic interviews to produce prototypes of responders and non-responders. (c) Clinical case-studies of sub-types of TRD and of change. DISCUSSION: TRD needs complex, long-term intervention and extended research follow-up for the proper evaluation of treatment outcome. This pushes at the limits of the design of randomised therapeutic trials,. We discuss some of the consequent problems and suggest how they may be mitigated. Trial registration Current Controlled Trials ISRCTN40586372
Generalised Quantum Theory—Basic Idea and General Intuition: A Background Story and Overview
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