抗抑郁药物和心理治疗:为什么重要

IF 0.5 Q4 PSYCHIATRY
Marco Chiesa
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引用次数: 0

摘要

许多患者在服用抗抑郁药物的同时进行心理治疗。本文概述并讨论了抗抑郁药物对患者和心理治疗过程的主要影响。尽管抗抑郁药物被广泛开处方,但其有效性仍有争议,一些作者质疑它是否比安慰剂更有效。抗抑郁药的多方面副作用包括情绪迟钝、性功能障碍、许多身体疾病和抑郁症的慢性病程。这些不良反应往往不容易确定是由药物引起的,可能被错误地归因于患者自己的情绪困难。这对心理治疗过程提出了挑战,有造成僵局和不利结果的风险。在大多数情况下,为了减少这些副作用对患者生活质量和心理治疗过程的影响,有必要逐步停止抗抑郁药物治疗。临床病例1例,患者有10年精神科药物治疗和住院史,患有药物应激不良反应,而精神状况没有改善。精神科药物的逐渐戒断,加上支持性和探索性心理治疗的结合,导致了更有利的预后和患者生活的明显改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antidepressant Medication and Psychotherapy: Why It Matters

Many patients enter psychotherapy while being on antidepressant medication. This article outlines and discusses the main effects of antidepressant medication both on the patient and on the psychotherapy process. Although widely prescribed, the effectiveness of antidepressant medication is still open to debate, and several authors have questioned whether it is more effective than placebo. The multi-faceted adverse effects of antidepressants include emotional blunting, sexual dysfunction, a number of physical ailments and chronicity in the course of depression. These adverse effects are often not easy to identify as stemming from the medication and may be mistakenly attributed to the patient's own emotional difficulties. This presents a challenge to the process of psychotherapy with the risk of creating an impasse and unfavourable outcome. In most cases, a gradual process of withdrawal from antidepressant medication is necessary to reduce the impact of these side effects both on the patient's quality of life and on the psychotherapy process. A clinical case of a patient with a 10-year history of psychiatric medication and hospitalisations, who was suffering from medication stressful adverse effects while not improving psychiatrically. A gradual withdrawal of psychiatric medication coupled with a combination of supportive and exploratory psychotherapy led to a more favourable prognosis and clear improvements in the patient's life.

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来源期刊
CiteScore
0.90
自引率
50.00%
发文量
91
期刊介绍: The British Journal of Psychotherapy is a journal for psychoanalytic and Jungian-analytic thinkers, with a focus on both innovatory and everyday work on the unconscious in individual, group and institutional practice. As an analytic journal, it has long occupied a unique place in the field of psychotherapy journals with an Editorial Board drawn from a wide range of psychoanalytic, psychoanalytic psychotherapy, psychodynamic, and analytical psychology training organizations. As such, its psychoanalytic frame of reference is wide-ranging and includes all schools of analytic practice. Conscious that many clinicians do not work only in the consulting room, the Journal encourages dialogue between private practice and institutionally based practice. Recognizing that structures and dynamics in each environment differ, the Journal provides a forum for an exploration of their differing potentials and constraints. Mindful of significant change in the wider contemporary context for psychotherapy, and within a changing regulatory framework, the Journal seeks to represent current debate about this context.
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