Mental Health – Treatment Collaborations
IN THIS 21ST CENTURY KNOWLEDGE SOCIETY, mental health services will increasingly need to develop treatment models that issue from alliances between increasingly differentiated fields of knowledge, where evidence demonstrating efficacy and effectiveness will come from collaborative interdisciplinary approaches (Gullestad, et al. 2024).[1]
Depression
The first quarter of the 21st century has seen major societal upheavals – especially acute over the last 10 years – due to technological developments, climate crises, the global pandemic, political unrest and the devastating effects of wars. WHO was reporting that by 2015 the total number of people with depression globally would exceed 300 million, while suicides already numbered 800,000 per year.
Here in Ireland, the Annual Report on the Activities of Irish Psychiatric Units and Hospitals 2023, based on data from the National Psychiatric Inpatient Reporting System (NPIRS) observes:
- depressive disorders had the highest rate of all admissions, 68.8 per 100,000 population.
- depressive disorders had the highest proportion of all (23%) and first (25%) admissions.
- re-admissions accounted for 63% of all admissions.
- depressive disorders accounted for 115,450 of the 774,211 bed days.
We also know now that people with a history of childhood trauma are at higher risk for recurring and persistent episodes of depression (chronic depression) as well as PTSD.
Psychoanalytic Treatment
Research has shown psychoanalytic therapy to be effective in the treatment of chronic depression. Very recent studies have shown that 70-80% of chronically depressed patients were able to achieve a lasting alleviation of their depressive symptoms in long-term psychotherapy, often in conjunction with structural change.
The LAC Study, 2024 The LAC study was a multicentre, controlled, single blind four-arm trial, with a preference and a randomized section (Leuzinger-Bohleber, et al. 2019).[1] This trial, conducted over a 5-year duration, had 252 participants between 21 and 60 years of age. Data assessment was made at entry (t0), at one year (t1), at 2 years (t2), at 3 years (t3), at 4 years (t4), at 5 years (t5).
https://doi.org/10.1177/0706743718780340 open access
The ‘KEY PRACTITIONER MESSAGE’ of the LAC depression study looking at 5-year outcomes after long-term psychoanalytic (PAT) and cognitive-behavioural (CBT) treatments (Beutal, Krakau, et al, 2022) was the following:
- Long-term cognitive behavioural and psychoanalytical treatments achieved lasting changes regarding depressive symptoms.
- Both treatments resulted in structural change, with greater changes following psychoanalytic treatment.
https://doi.org/10.1192/bjp.2024.112 open access
THIS SYMPOSIUM will centre on drawing attention to this most recent, important research. Together we will give psychoanalysts, psychologists, psychiatrists, psychotherapists and other stakeholders in mental health services provision, the chance to hear about the research from Dr Lina Krakau, one of the lead authors reporting the work, to ask questions, to discuss and to get to grips with the significance of the findings.
We will also hear from Professor Marianne Leuzinger-Bohleber, the leading figure in the architecture of this and other prominent psychoanalytic research studies, carried out with great sophistication over a grand scale, involving several hundreds of clinically depressed patients, over two hundred therapists, as well as researchers, in multiple sites across the EU, the UK and the USA.
In addition, Jane G. Tillman, PhD., ABPP, Evelyn Stefansson Nef Director of the Erikson Institute for Education, Research, and Advocacy at the Austen Riggs Residential Psychiatric Centre, Stockbridge, Massachusetts, will join us to talk about psychoanalytic research and treatment in Institutional and community settings in the US.
We in Ireland, and elsewhere, are in the lucky position of being able to have access to this outstanding research, to be able to learn about it and to be able to use it.