Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 25

ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS I
those patients who could benefit from psychodynamic treatment
where other approaches fail.
S — III / 2 Thursday 14/8,11:00-12:30
The scope of brain imaging in the research of the
outcome of psychotherapy
Lclitonen J, Professor, Department of Psychiatry, Department of Clinical Physiology,
Department of Forensic Psychiatry, University of Kuopio and Niuvanniemi Hcspital, PO
ox 1777 FIN-70211, Kuopio, Finland. Saarinen P, Kuikka J, Joensuu M, Tolmunen T,
Ahola P, Tiihonen J.
Jof>tinnes.lehlonen@kuh.fi
Only a couple of years ago knowledge of connections between
brain function and psychotherapy was non-existent. New imaging
methods have rapidly changed the situation and there are already
several reports showing changes in blood flow, transporter or recep-
tor function that relate to psychotherapy outcome. Assessment of
valid connections between the effects of psychotherapy and brain
function requires careful exclusion of numerous confounding fac-
tors. We describe a protocol for studying the effects of dynamic
psychotherapy in depression using a randomised patient- waiting
hst control paradigm. Only drug-nai've patients are recruited. A
model for assessing the therapy process that typically arises with
patients with depression is also described. Preliminary results are
presented.
S-ll|/3 Thursday 14/8,11:00-12:30
PET studies of outcome of dynamic psychotherapy
Karlsson H, Professor, University of Turku, FIN-20014, Finland. Hietala J, Salminen J,
Kajander J.
Hasse. Karlsson@utu.fi
During recent years a few studies looking at brain correlates of
successful psychotherapy have been performed. These studies have,
however, utilised other forms of psychotherapy than psycho-
dynamic psychotherapy. In these studies the outcome variable has
been cerebral metabolism. No studies looking at changes in
receptor densities after psychotherapy have been published so far.
In this paper I present a study performed in Turku, Finland. We
recruited patients suffering from major depression from the
occupational health services, randomised them in two groups, one
receiving fluoxetine medication, and the other brief psychodynamic
psychotherapy. Among the many outcome measures was change in
5HT1A- and D2-receptor densities measured using positron emis-
sion tomography (PET). These measurements were performed
before the treatment, at 4 months, and one year. The results are
currently being analysed and will be presented at the congress.
S-lll/4 Thursday 14/8,11:00-12:30
Outcome of psychodynamic psychotherapy measured by
[123l]nor-p-CIT SPET-imaging
Joensuu M, MD, Departments of Psychiatry, Clinical Physiology, University Hospital of
Kuopio, Department of Forensic Psychiatry, University of Kuopio (Niuvanniemi Hospi-
tal), PO Box 1777 FIN-70211, Kuopio, Finland. Saarinen PI, Tolmunen T, Kuikka J,
Ttihonen J, Ahola P, Lehtonen J.
mikko.joensuu@kuh.fi
Background: Psychodynamic psychotherapy is a widely practised
form of psychotherapy in the treatment of depression. There is evi-
dence that SERT and DAT densities are altered in depression. Pre-
liminary observations have suggested that SERT function may re-
cover in connection of dynamic psychotherapy. In our study
[i23|]nor-p-CIT SPET is used in imaging of serotonin and dopamine
transporter function.
Ainis: The objective is to find out if there are changes in the densi-
ties of serotonin and/or dopamine transporters related to clinical
recovery during psychodynamic psychotherapy.
Method: Twenty five drug-nai've currently depressed (moderate/
severe) patients with no previous treatment will be recruited for
this study. The patients are randomised to psychotherapy and
waiting-list control groups. For controls, psychotherapy is started
after a 6-months waiting-time. SPET-imaging is performed at base-
line and after 12-months of psychotherapy. For the controls addi-
tional imaging is performed after 6-months waiting-time.
Results: Preliminary results of patients studied so far will be pre-
sented in form of case reports.
Conclusions: SERT densities in n.raphe may correlate to the symp-
tomatic recovery of depression during psychodynamic psycho-
therapy.
S-lll/5 Thursday 14/8, 11:00-12:30
Character, symptoms and relationship patterns before
and after dynamic psychotherapy
Alexander Wilczek, MD, PhD, Dept. of Clinical Neuroscience, Karolinska Institutet.
Björngárdsgatan 25, SE 118 52 Stockholm, Sweden. Robert M Weinryb, Jacques P
Barber, J Petter Gustavsson, Marie Ásberg.
alexander. wilczek@pi.ki.se
Background: In psychoanalytic theory, character is conceived as a
regulating structure intended for life-long adaptation between
inner needs and outer reality. If this adaptation fails, symptoms and
dysfunctional relationship patterns might emerge, implying a close
association between svmptoms, relationship patterns, and under-
lying character. Furthermore, improvements regarding symptoms
and relationships are regarded as consequences of change in
character structure.
Aims: To study 1) the psychiatric and demographic characteristics
of patients selected for long-term dynamic psychotherapy in a
naturalistic clinical setting; 2) the relationship between character,
symptoms and relationship patterns in these patients; 3) the change
in character, symptoms, and relationship patterns following psycho-
therapy; 4) whether change in one of these three aspects was inter-
related with change in any other aspect; 5) the relationship between
change and duration of treatment or frequency of sessions.
Læknablaðið / FYLGIRIT 48 2003/89 25