Psychological vs biological therapy for treating mental illness

Answer from top 10 papers

The efficacy of psychological versus biological therapy in treating mental illness is a subject of ongoing research and debate. Psychological therapies, such as psychotherapy and cognitive-behavioral therapy (CBT), focus on addressing mental and emotional problems through various psychological techniques (Wen & Li, 2019). Biological therapies typically involve pharmacological interventions targeting the biological underpinnings of mental disorders (Röhricht, 2014).
Studies have shown that both psychological and biological treatments can be effective. For instance, in the treatment of major depressive disorder in youth, no significant differences were found among group Rational Emotive Behavior Therapy (REBT)/CBT, pharmacotherapy, and their combination, suggesting that all approaches were beneficial (Sandberg & Busch, 2012). Similarly, body psychotherapy (BPT) has been demonstrated to contribute substantially to the treatment of severe mental disorders (Iftene et al., 2014), and sandplay therapy has shown clinical efficacy in treating various mental disorders (Peters et al., 2020). However, there is also evidence that the framing of mental illness can influence treatment preferences, with essentialist explanations leading to a preference for drug treatments (Röhricht, 2014).
In conclusion, both psychological and biological therapies have their place in the treatment of mental illness, with the choice of therapy often depending on the specific disorder, individual patient characteristics, and treatment preferences. While some studies suggest comparable efficacy between the two types of therapy (Sandberg & Busch, 2012), others highlight the importance of considering the patient's perception and the framing of mental illness (Röhricht, 2014). Therefore, an integrative approach that considers both psychological and biological aspects may be the most beneficial for treating mental illness (Wang et al., 2020; Wen & Li, 2019).

Source Papers

Rational-emotive and cognitive-behavior therapy (REBT/CBT) versus pharmacotherapy versus REBT/CBT plus pharmacotherapy in the treatment of major depressive disorder in youth; A randomized clinical trial

Major depressive disorder is a highly prevalent and debilitating condition in youth, so developing efficient treatments is a priority for mental health professionals. Psychotherapy (i.e., cognitive behavioral therapy/CBT), pharmacotherapy (i.e., SSRI medication), and their combination have been shown to be effective in treating youth depression; however, the results are still mixed and there are few studies engaging multi-level analyses (i.e., subjective, cognitive, and biological). Therefore, the aims of this randomized control study (RCT) were both theoretical - integrating psychological and biological markers of depression in a multi-level outcome analysis - and practical – testing the generalizability of previous results on depressed Romanian youth population. Eighty-eight (N=88) depressed Romanian youths were randomly allocated to one of the three treatment arms: group Rational Emotive Behavior Therapy (REBT)/CBT (i.e., a form of CBT), pharmacotherapy (i.e., sertraline), and group REBT/CBT plus pharmacotherapy. The results showed that all outcomes (i.e., subjective, cognitive, and biological) significantly change from pre to post-treatment under all treatment conditions at a similar rate and there were no significant differences among conditions at post-test. In case of categorical analysis of the clinical response rate, we found a non-significant trend favoring group REBT/CBT therapy. Results of analyses concerning outcome interrelations are discussed.

Reframing mental illness: The role of essentialism on perceived treatment efficacy and stigmatization.

People believe that treatments for illnesses are effective when they target the cause of the illness. Prior work suggests that biological essentialist explanations of mental illness lead people to prefer medications or other pharmacological treatments. However, prior work has not distinguished between biological and essentialist explanations. In three studies (total n = 517), we presented adults with vignettes about an individual with an artificial mental illness and manipulated the descriptions to emphasize or de-emphasize essentialist characteristics. Critically, none of the vignettes made reference to a biological basis for the disorder. Participants rated their willingness to interact with the person described in the vignettes and how effective they believed drug treatment and talk therapy would be on the mental illness. Across the three studies, describing mental illness with an essentialist framing led participants to think drug treatments would be more effective, but there was no effect for stigma or perceived effectiveness of talk therapy. This effect appears to be mediated by how much participants essentialized individuals with the disorder. The first framing that participants encountered seemed to shape their reasoning for the remainder of the study, even if they saw conflicting framing later on. The framing manipulation had similar effects for individuals with and without a mental illness. Results suggest that it is important to consider how mental illness is framed to the general public as it might impact people's treatment preferences.

Open Access
Improvement in Psychological Condition of Patients With Persistent Moderate–Severe Allergic Rhinitis by Drug Therapy Combined With Psychological Intervention

To investigate the effect of drug treatment combined with psychological intervention on mental disorders in patients with persistent moderate-severe allergic rhinitis. Sixty patients with persistent moderate-severe allergic rhinitis who met the criteria were randomly divided into 2 groups: control group and experimental group. The control group was only given medication, whereas the experimental group was given psychological intervention on the basis of the same medication. Cognitive behavioral therapy was used for psychological intervention. After 12 weeks of treatment, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) were used to evaluate the changes in anxiety, depression, and quality of life before and after treatment. The SAS and SDS scores of the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similarly, the SAS and SDS scores of the experimental group after treatment were lower than those before treatment with statistically significant difference. In addition, after treatment, the SAS and SDS scores of the experimental group were statistically lower than those of the control group. The results of RQLQ showed that the scores of each dimension in the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similar results were found in the experimental group. After treatment with these 2 different schemes, the RQLQ scores of sleep, nonnasal/eye symptoms, and emotion in the experimental group were statistically lower than those in the control group. Drug therapy or drug therapy combined with psychological intervention can alleviate anxiety and depression of patients with persistent moderate-severe allergic rhinitis and improve their quality of life. Moreover, based on the effect of improving mental disorder and quality of life of patients, drug therapy combined with psychological intervention is better than drug treatment alone.

Open Access