Despite advances in psychiatry, treatment outcomes are still a big problem, and are not always substantially better than it was in the past time. Treatment resistance remains a serious psychiatric problem. One of the reasons for that is that the pendulum has swung from a psychodynamic framework to a biological one, and the impact of meaning (i.e. the role of psychodynamic and psychosocial factors in treatment-refractory illness) has been relatively neglected. Dynamic factors in psychopharmacology play a pivotal role in pharmacological treatment responsiveness. There is a small but impressive evidence base that shows that psychological and interpersonal factors play that role. Psychodynamic psycho pharmacotherapy combines rational prescribing with tools to identify irrational interferences with effective use of medications, i.e. to resolve the problems of the pharmacological-treatment resistance. Psychodynamic psychopharmacology represents an integration of biological psychiatry and psychodynamic insights and techniques.
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Am J Psychother
January 2025
Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, Connecticut (O'Connell); Austen Riggs Center, Stockbridge, Massachusetts (Mintz).
Objective: Pharmacotherapy outcomes may be influenced as much by psychosocial factors as by medication. Comprehensive discussion of such factors may contribute to better patient outcomes and may counter aspects of a curriculum that prioritizes efficiency and that has the potential to undermine clinician empathy. This pilot study aimed to explore the benefits of teaching psychosocial aspects of prescribing and student acceptance of such teaching.
View Article and Find Full Text PDFBehav Sci (Basel)
December 2024
Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Florence, Italy.
In certain situations, romantic engagement with a partner can have detrimental effects on an individual's well-being and overall health, exhibiting features attributable to addictive behaviors. Considering the clinical significance of this phenomenon and its prevalence among adolescents and young adults, the objective of this study was to investigate the potential associations between some risk factors for love addiction in a sample of university students, with a specific focus on adult attachment, separation anxiety, and defense mechanisms. A total of 332 participants (M = 23 years; SD = 2.
View Article and Find Full Text PDFHarv Rev Psychiatry
January 2025
From McLean Hospital (Mr. Mermin and Dr. Choi-Kain) Belmont, MA; Harvard College (Ms. Steigerwald); Harvard Medical School (Dr. Choi-Kain).
Borderline personality disorder (BPD) has been described as a condition of intolerance of aloneness. This characteristic drives distinguishing criteria, such as frantic efforts to avoid abandonment. Both BPD and loneliness are linked with elevated mortality risk and multiple negative health outcomes.
View Article and Find Full Text PDFPsychiatr Danub
December 2024
School of Medicine, University of Zagreb, Zagreb, Croatia.
This review article explores the relationship between psychodynamic factors, personality organization, and loneliness. It focuses on extensive research into attachment styles, shame, pathological narcissism, and personality disorders. Insecure attachment styles, both anxious and avoidant, emerge as significant predictors of loneliness.
View Article and Find Full Text PDFJ Psychiatr Pract
November 2024
Medical Director/CEO, The Austen Riggs Center, Stockbridge, MA; and Founder, American Psychiatric Association Psychotherapy Caucus, Washington, DC.
This column addresses the role of dreams in psychoanalysis and psychodynamic therapy. It includes an autobiographical perspective on how a dream led this psychiatrist to become a psychoanalyst and an introduction to social dreaming.
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