Talking therapy changes the brain

Researchers from Massachusetts General Hospital (MGH) have identified changes in the metabolic activity of a key brain region in patients successfully treated for depression with psychodynamic psychotherapy – talking therapy.

The study involved 16 patients with major depression who were offered weekly psychodynamic psychotherapy sessions. Each of the participants had unsuccessfully tried treatment for their depression with medication. Nine of the patients completed the course of psychotherapy and ‘almost all’ reported a greater than 50% reduction in their depression. Read more Talking therapy changes the brain

Depressed parents and their children

Medscape has recently carried two reports on studies that looked at the effects of parental depression.

One report looked at a study published in Pediatrics, which looked at links between depression in fathers and their parenting behaviour. The study was particularly interested in parenting behaviour that could negatively affect the child’s development, including the physical punishment of young children or the absence of shared activities, such as reading to the child.

The study looked at 1,746 fathers drawn form the Fragile Families and Child Wellbeing Study (FFCWS), an ongoing study that looks at a representative cohort of children born in the United States between 1998 and 2000. Families were recruited at the child’s birth and the fathers were interviewed when the child was one year old. Seven percent of the fathers reported a major depressive episode in the previous 12 months; many of these men were unemployed or also reported substance misuse.

Fathers identified as experiencing depression were:

  • More likely to have hit their child (41% of depressed fathers had spanked their child in the previous month, compared to 13% of non-depressed fathers),
  • Less likely to have read to their child (41% of depressed fathers had read to their child at least three times in the previous week, compared to 58% of non-depressed fathers).

Some points made by the study include:

  • That while some may argue for the use of corporal punishment in older children, its use in children under one year is very problematic.
  • That the increased likelihood of spanking by these fathers may be linked to some of the symptoms of depression, such as irritability and anger.
  • That around half of all fathers interviewed in the FFCWS thought that discipline was one of their key roles, even with younger children.
  • That over three quarters of all fathers had spoken to a pediatrician about their child in the previous year, presenting opportunities for screening for depression and for a discussion about parenting behaviour.

The study authors pointed to several limitations of their study, including the possibility that children with a difficult temperament might result in both negative parental behaviour and parental depression.

The second report in Medscape describes a study of 80 mothers and their children who participated in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. The study looked at mothers who were experiencing major depression and whose children also experienced psychiatric symptoms and problem behaviours.

The study showed improvements in the children of mothers whose depression improved in treatment. This was not the case for the children of mothers whose depression did not improve, in fact there was an increase in the problematic behaviour of children whose mothers did not get better.

(Questions have been raised about the overall STAR*D programme, which was intended to test the effectiveness of anti-depressants. There are claims that the methodology used in the trial and the way that the trail was reported both overestimated the evidence for the effectiveness of drug treatments for depression. For example, see this article in Psychology Today.)

These two reports remind us of the crucial need to provide support for parents to avoid later problems for the children. Both mothers and fathers can experience depression following the birth of a child and those early months are so important for the baby’s emotional and intellectual development. Often today that support is not available from an extended family and other help needs to be available.

via Medscape (free registration required)