Differences between effects of psychological versus pharmacological treatments on functional and morphological brain alterations in anxiety disorders and major depressive disorder: A systematic review

The most prevalent mental disorders, anxiety and mood disorders, are associated with both functional and morphological brain changes that commonly involve the 'fear network' including the (medial) prefrontal cortex, hippocampus and amygdala. Patients suffering from anxiety disorders and ma...

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Vydané v:	Neuroscience and biobehavioral reviews Ročník 36; číslo 1; s. 626 - 644
Hlavní autori:	Quidé, Yann, Witteveen, Anke B., El-Hage, Wissam, Veltman, Dick J., Olff, Miranda
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Kidlington Elsevier 01.01.2012
Predmet:	Adult and adolescent clinical studies Anxiety Disorders - drug therapy Anxiety Disorders - pathology Anxiety Disorders - rehabilitation Behavior therapy. Cognitive therapy Behavioral psychophysiology Biological and medical sciences Brain - drug effects Brain - pathology Brain - physiopathology Depression Depressive Disorder, Major - drug therapy Depressive Disorder, Major - pathology Depressive Disorder, Major - rehabilitation Fundamental and applied biological sciences. Psychology Humans Medical sciences Mood disorders Psychology. Psychoanalysis. Psychiatry Psychology. Psychophysiology Psychopathology. Psychiatry Psychotherapy - methods Psychotropic Drugs - therapeutic use Treatments Anxiety disorders Central nervous system Anxiety disorder Pharmacotherapy Psychotherapy Review IPT Major depressive disorder Encephalon Selective serotonin reuptake inhibitor CBT Imaging EMDR Functional neuroimaging Behavior therapy Eye movement desensitization and reprocessing Mood disorder Cognitive therapy Brain imaging Depression Psychological effect SSRI Treatment Morphology Comparative study Structural neuroimaging Functional imaging
ISSN:	0149-7634, 1873-7528, 1873-7528
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Popis
Shrnutí:	The most prevalent mental disorders, anxiety and mood disorders, are associated with both functional and morphological brain changes that commonly involve the 'fear network' including the (medial) prefrontal cortex, hippocampus and amygdala. Patients suffering from anxiety disorders and major depressive disorder often show excessive amygdala and reduced prefrontal cortex functioning. It is, however, still unclear whether these brain abnormalities disappear or diminish following effective treatment. This review aims to compare the effects of psychotherapy and pharmacotherapy on functional and morphological brain measures in these disorders. Sixty-three studies were included, 30 investigating psychotherapy effects and 33 investigating pharmacotherapy effects. Despite methodological differences, results suggest a functional normalization of the 'fear network'. Pharmacotherapy particularly decreases over-activity of limbic structures (bottom-up effect) while psychotherapy tends to increase activity and recruitment of frontal areas (top-down effect), especially the anterior cingulate cortex. Additionally, pharmacotherapy, but not psychotherapy, has been associated with morphological changes, depending on the disorder. These findings suggest that both types of treatments normalize (functional) brain abnormalities each in specific ways.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 ObjectType-Undefined-4 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0149-7634 1873-7528 1873-7528
DOI:	10.1016/j.neubiorev.2011.09.004