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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Bibliographic Details
Published in:Neuroscience and biobehavioral reviews Vol. 36; no. 1; pp. 626 - 644
Main Authors: Quidé, Yann, Witteveen, Anke B., El-Hage, Wissam, Veltman, Dick J., Olff, Miranda
Format: Journal Article
Language:English
Published: Kidlington Elsevier 01.01.2012
Subjects:
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
Online Access:Get full text
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Summary: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.
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ISSN:0149-7634
1873-7528
1873-7528
DOI:10.1016/j.neubiorev.2011.09.004