Will neuroscience account for the psychotherapeutic outcome in schizophrenia?
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Arch Psych Psych 2009;11(3):11–16
Neuroscientific research explaining the effectiveness of psychotherapy went in three directions. The first, basing on a theory of explicit (declarative, conscious) and implicit (procedural, subconscious) memory aims at reinterpretation of the mechanisms of psychotherapy. This method is useful in analysing effects of cognitive psychotherapy but also psychoanalytically oriented psychotherapy which is based on interpretations and insight. The second current in such research is connected with the possibility of neuroimaging, which allows to evaluate changes occurring in the course of therapy. This method enables to show biological mechanisms of therapeutic alliance or reduction of basic anxiety. In the third category of studies, changes in cerebral metabolism that occur due to psychotropic medication and psychotherapy are observed with the aid of neuroimaging. Here, the findings are extremely interesting, for instance, in treatment of depression psychotherapy brings about more specific changes than anti-depression drugs. Most of the investigation is focused on the effects of psychotherapy for patients suffering from depression and obsessive-compulsive disorder because of high homogeneity of these disorders. Schizophrenia-related disorders are less homogeneous, and owing to that drafting a research plan is a much more complicated task. So the path towards neuroscience, which may account for the effects of psychotherapy, is still unexplored.