Psychotherapy has drug-like effect on the brain

There is now widespread evidence that successful psychological therapies induce changes to brain function, often in a way comparable to drug treatments. That’s according to a new review by Veena Kumari at the Institute of Psychiatry.

Take the example of depression: a recent brain imaging study found recovery was associated with decreased metabolism in the ventrolateral prefrontal cortex, both in patients who had improved after taking Seroxat, and in patients who had undergone successful cognitive behavioural therapy (CBT). Successful CBT was also associated with brain changes not seen with Seroxat, including increased activity in the cingulate, frontal and hippocampus regions, probably reflecting a cortical ‘top down’ mechanism of action.

Or consider the treatment of obsessive compulsive disorder: another brain imaging study found recovery was associated with similar changes in the right caudate metabolic rate, following either behavioural therapy or Prozac.

Elsewhere, more research is needed. CBT is often beneficial to schizophrenia patients who don’t respond to antipsychotic medication but no research has yet been published on the neural correlates of this benefit.

“The reviewed studies clearly demonstrate that psychological interventions, such as CBT, are able to modify activity in dysfunctional neural circuitries linked to the development of various psychopathological conditions” Kumari concluded.

In fact, she added that psychotherapy may provide a clearer insight into the brain changes associated with recovery from mental illness because “it has minimal side-effects (if any) and [unlike drugs] lacks direct pharmaceutical actions to obscure brain changes directly related to behavioural change…”.
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Kumari, V. (2006). Do psychotherapies produce neurobiological effects? Acta Neuropsychiatrica, 18, 61-70.

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