Short-Term Psychodynamic Psychotherapy in Patients with “Male Depression” Syndrome, Hopelessness, and Suicide Risk: A Pilot Study

Gloria Angeletti,Marco Innamorati,Paolo Girardi,Mark Goldblatt,Valeria Savoja,Maurizio Pompili,Chiara Santucci

doi:10.1155/2013/408983

Abstract

Objectives and Methods. This was an observational study of the efficacy of short-term psychodynamic psychotherapy (STPP) in a sample of 35 (30 women and 5 men) patients with moderate-to-severe “male depression” (Gotland Scale for Male Depression (GSMD) ≥ 13) comorbid with unipolar mood disorder (dysthymia and major depression) or anxiety disorder. Outcome measures were GSMD and BHS (Beck Hopelessness Scale) score changes from baseline. Results. Patients had a strong response to STPP on the GSMD (estimated mean score change (± SE) = −9.08 ± 2.74; P < 0.01; partial eta squared = 0.50), but not on the BHS (estimated mean score change (± SE) = −0.92 ± 1.55; P = 0.57; partial eta squared = 0.03). BHS score changes were significantly associated with GSMD score changes (Pearson's r = 0.56; P < 0.001), even when controlling for the severity of hopelessness at the baseline (partial r = 0.62; P < 0.001). Conclusions. STPP proved to be effective in patients suffering from “male depression” although hopelessness was only marginally reduced by this treatment which points to the need to better understand how STPP can be involved in the reduction of suicide risk.

Highlights

While cognitive-behavioral therapy and interpersonal therapy continue to have the most evidence for efficacy [15], some randomized trials and metaanalyses indicated that short-term psychodynamic psychotherapy (STPP) could be effective in reducing symptoms and in improving functional ability of patients with mild or moderate depression [16,17,18,19,20]
Inclusion criteria were the presence of moderate-to-severe “male depression” syndrome as assessed by the GSMD, ages between 18 and 64 years old, and a diagnosis of a mood disorder or anxiety disorder
Beck et al [33] carried out a prospective study of 1,958 outpatients and found that Beck Hopelessness Scale (BHS) scores were related signi cantly to eventual completed suicide

Summary

Introduction

E term “depression” encompasses a wide range of conditions that may occur along a continuum, ranging from milder forms of discomfort to more severe and persistent form, as in the case of major depression. E NICE guideline indicated that it was not possible to demonstrate a consistent picture of any clinically important bene t for short-term psychodynamic psychotherapy (STPP) in depression. While cognitive-behavioral therapy and interpersonal therapy continue to have the most evidence for efficacy [15], some randomized trials and metaanalyses indicated that STPP could be effective in reducing symptoms and in improving functional ability of patients with mild or moderate depression [16,17,18,19,20]. Male depression was found to be severe in men and women who had made a nonviolent suicide attempt [24]. No psychological therapies have been assessed for their efficacy in the treatment of male depression. We hypothesize that the reduction in male depression will be signi cantly associated with a reduction of hopelessness, a proxy of suicide risk

Materials and Methods

Results

Discussion

Findings

Conclusions