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Home > Archive > Depression Medications > August 2004 > Scientists: Antidepressants and cognitive therapy both effective on brain activity
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Scientists: Antidepressants and cognitive therapy both effective on brain activity
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| bobwhelan 2004-08-25, 12:19 pm |
| Despite the more lasting benefits of therapy, the use of
antidepressants is rising steadily, reflecting the push by insurers to
have patients treated by primary-care physicians rather than
specialists. But pills exert their effect only as long as a patient
takes them, and the risk of relapse in the coming year is 80%,
compared with 25% for patients in cognitive therapy. Neuroscientists
in Canada compared two groups of patients, one taking antidepressants
and the other receiving therapy.
The results agreed with past studies, finding that comparable
improvement took place. But brain scans showed that each treatment had
affected a different part of the brain. Pills, they found, worked to
reduce activity in the brain's emotion or limbic centers. Therapy
worked on the cortex, which is the seat of higher thought, giving
patients an "override capacity," explained one psychiatrist, "so when
sad feelings bubble up from the brain's emotion centers, people can
resist being drawn down into depression."
These findings can lead the way, says this article, to combining the
two treatments more effectively to give patients a better chance at
overcoming depression for good.
bobwhelan
"Studies have found that after 3 months of antidepressant
treatment between 50% and 65% of the people who take them
will be much improved. This compares
with 25 - 30% of people given an inactive "dummy" pill,
or placebo."
- The British Journal of Psychiatry
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| Larry Hoover 2004-08-25, 12:19 pm |
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"Squiggles" <squiggle@sympatico.ca> wrote in message
news:4124924A.1060206@sympatico.ca...
> I think that "empiricism" in psychiatry would be closer
> to behaviourism (as in Skinner).
No, I totally disagree. You cannot test for thought content. Predictability
of response is part of the equation, and evoked potentials can be measured,
but we cannot correlate that to thinking processes, literally. Unless, that
is, you think there is a way to measure subconscious brain activity and
content.
> This looks more like
> interpretation of what goes on in the brain as seen
> through new techniques.
Ergo, empirical evidence. We know what the prefrontal cortex does, by
studying those with damage thereto. Frontal lobotomy, anyone?
> But just about any scientific
> endeavour has a hard time being strictly empirical, as
> a conclusion is always sought.
Empiricism is about hypothesis testing, and the scientific method. Anything
that cannot be falsified is not empirical.
> I suppose this
> study is more empirical than an inductive one where
> numerous cases are collected and group to arrive at
> a conclusion (that would be inductive and not deductive).
I don't believe there is such a thing as absolute empiricism. That's the
whole point behind probability testing and significance (statistical
analysis).
> Squiggles
>
> dfn.: Empiricism - for scientific method:
> http://encyclopedia.thefreedictiona...uctive%20method
>
>
> Squiggles
Uh, no, that is not the definition given for empiricism.
Hypothetico-deductive reasoning is one component of the scientific method,
but it is not a required aspect of empirical science. For example, you don't
need an hypothesis to measure the freezing temperature of water, or the
humidity in your house.
From your source:
"Empirical is an adjective often used in conjunction with science, both the
natural and social sciences, which means an observation or experiment based
upon experience that is capable of being verified or disproved. "
Lar
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| Larry Hoover 2004-08-25, 12:19 pm |
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"Squiggles" <squiggle@sympatico.ca> wrote in message
news:4124AFC5.6050100@sympatico.ca...
>
> Interpretation is not empirical evidence.
WITH the brain scans, it is.
>
> I agree with that. What would be absolute empiricism after and what
> use would it be to us;
The full and total truth, without any doubt. P = 0 (But that is
unachievable, despite it being the target of science, at least
figuratively.)
If you can't find a use for that, what's the point of looking in the first
place?
> but it is essential to objectivity in collecting
> the data.
What is essential to objectivity? You speak in riddles.
Look, it's no wonder you snipped this part, as it answers the question under
debate.
I said:
Hypothetico-deductive reasoning is one component of the scientific method,
but it is not a required aspect of empirical science. For example, you don't
need an hypothesis to measure the freezing temperature of water, or the
humidity in your house.
The act of making a measurement or recording an observation is empirical, by
definition, if it can be verified or disproved.
From your source:
"Empirical is an adjective often used in conjunction with science, both the
natural and social sciences, which means an observation or experiment based
upon experience that is capable of being verified or disproved. "
'Empirical....science' applies to both observations, in their pure form, and
to hypothesis-testing by experiment. *Two realms*, neither mutually
exclusive of the other.
Lar
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| Larry Hoover 2004-08-25, 12:19 pm |
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"Squiggles" <squiggle@sympatico.ca> wrote in message
news:4123567D.1090808@sympatico.ca...
> That and a dime might get you a cup of coffee. :-!
>
> Squiggles
I don't have the slightest idea what you're trying to say.
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| Sun Moon 2004-08-25, 12:19 pm |
| x-no-archive: yes
http://www.angermgmt.com/measure.html
"bobwhelan" <bobwhelan@postmaster.co.uknospam> wrote in message
news:s8o6i0d2jbeau2mva2h3a11jc5ckoctc9n@4ax.com...
> Despite the more lasting benefits of therapy, the use of
> antidepressants is rising steadily, reflecting the push by insurers to
> have patients treated by primary-care physicians rather than
> specialists.
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| Larry Hoover 2004-08-25, 12:19 pm |
|
"Squiggles" <squiggle@sympatico.ca> wrote in message
news:4123F6CF.7000803@sympatico.ca...
>
>
> Larry Hoover wrote:
>
>
> I mean that this theory looks leaky.
>
> Squiggles
It isn't a theory. It's empirical.
Arch Gen Psychiatry. 2004 Jan;61(1):34-41.
Modulation of cortical-limbic pathways in major depression:
treatment-specific effects of cognitive behavior therapy.
Goldapple K, Segal Z, Garson C, Lau M, Bieling P, Kennedy S, Mayberg H.
Rotman Research Institute at Baycrest Centre, 3560 Bathurst Street, Toronto,
Ontario, Canada M6A 2E1.
BACKGROUND: Functional imaging studies of major depressive disorder
demonstrate response-specific regional changes following various modes of
antidepressant treatment. OBJECTIVE: To examine changes associated with
cognitive behavior therapy (CBT). METHODS: Brain changes underlying response
to CBT were examined using resting-state fluorine-18-labeled deoxyglucose
positron emission tomography. Seventeen unmedicated, unipolar depressed
outpatients (mean +/- SD age, 41 +/- 9 years; mean +/- SD initial 17-item
Hamilton Depression Rating Scale score, 20 +/- 3) were scanned before and
after a 15- to 20-session course of outpatient CBT. Whole-brain, voxel-based
methods were used to assess response-specific CBT effects. A post hoc
comparison to an independent group of 13 paroxetine-treated responders was
also performed to interpret the specificity of identified CBT effects.
RESULTS: A full course of CBT resulted in significant clinical improvement
in the 14 study completers (mean +/- SD posttreatment Hamilton Depression
Rating Scale score of 6.7 +/- 4). Treatment response was associated with
significant metabolic changes: increases in hippocampus and dorsal cingulate
(Brodmann area [BA] 24) and decreases in dorsal (BA 9/46), ventral (BA
47/11), and medial (BA 9/10/11) frontal cortex. This pattern is distinct
from that seen with paroxetine-facilitated clinical recovery where
prefrontal increases and hippocampal and subgenual cingulate decreases were
seen. CONCLUSIONS: Like other antidepressant treatments, CBT seems to affect
clinical recovery by modulating the functioning of specific sites in limbic
and cortical regions. Unique directional changes in frontal cortex,
cingulate, and hippocampus with CBT relative to paroxetine may reflect
modality-specific effects with implications for understanding mechanisms
underlying different treatment strategies.
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