Attributional retraining group therapy versus selective serotonin reuptake inhibitors: neurobiological effects

Abstract

Objective To compare the effects on neurobiological factors of attributional retraining group therapy (ARGT) or selective serotonin reuptake inhibitors (SSRI) for major depressive disorder (MDD), anxiety disorder (AD) and obsessive-compulsive disorder (OCD). Methods Outpatients with MDD, AD and OCD were divided into ARGT group (n=63) and SSRI group (n=66) according to the sequence of entering the study.MDD, AD and OCD patients were respectively measured with Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and after 8 weeks treatment.All subjects were detected of plasma serotonin, norepinephrine, cortisol and adrenocorticotropic hormone by radioimmunoassay before and after treatment. Results After treatment, HAMD scores of MDD patients were reduced significantly in both ARGT group (t=18.411, P=0.000) and SSRI group (t=20.092, P=0.000); HAMA scores of GAD patients were reduced significantly in both ARGT group (t=13.989, P=0.000) and SSRI group (t=15.815, P=0.000); Y-BOCS scores of OCD patients were reduced significantly in both ARGT group (t=5.465, P=0.000) and SSRI group (t=4.792, P=0.000). In ARGT group, MDD (t=3.145, P=0.006), AD(t=2.785, P=0.012)and OCD patients (t=2.877, P=0.011) decreased plasma cortisol concentrations significantly.In SSRI group, MDD (t=-2.923, P=0.010) and OCD patients (t=-2.301, P=0.035) improved plasma serotonin significantly and MDD patients (t=-2.333, P=0.033) improved plasma norepinephrine significantly. Conclusion ARGT can modulate plasma cortisol level.SSRI can up-modulate plasma serotonin level.The two therapies take effect by different biological ways. Key words: Attributional retraining group therapy; Psychotherapy; Selective serotonin reuptake inhibitors; Neurobiological effects; Serotonin