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A Study In This Month's Journal Of Nervous And Mental Disease Reveals Hope For Recovery From Suicidal Thinking And Treatment Resistant Mental Illness
Date:1/15/2009

, among patients diagnosed with borderline personality disorder -- a collection of self-destructive, unstable and impulsive behaviors that lead to suicide in about 7% of those with the disorder and that many clinicians find intractable -- an astonishing 74 percent had no active symptoms after six years. Only six percent had relapsed into the full-blown disorder. At the Personality Disorders Institute at Cornell's Weill Medical College, randomized controlled trials have shown that borderline patients make lasting improvements with a psychodynamic treatment called "transference focused psychotherapy."

What's all the more striking is that impressive outcomes in previously "treatment resistant" patients can be produced by a treatment method -- long-term psychodynamic psychotherapy -- that has for decades been dismissed as a mere historical curiosity. In an age of drug treatments and managed care, the "talking cure" practically disappeared from mainstream medical practice. Whereas psychiatric residents once devoted half their training hours to long-term psychotherapy, it's now shrunk to a puny 2.5 percent. But in a landmark meta-analysis of 23 studies involving more than a thousand patients, researchers found the method demonstrably effective, with long-lasting benefits. The study, published in the Journal of the American Medical Association in 2008, marked what one academic described to The New York Times as a "turning point" for the psychodynamic approach.

At a time when many mental health clinicians are grappling with these treatment resistant patients with complex and severe mental illnesses, any sign of hope is cause for celebration. Citations referring to treatment resistance shot up 800 percent over the last two decades -- an interest that reflects the massive number of cases. With schizophrenia, for example, 10 to 30 percent of patients fail to respond to treatment at all -- and another 30 per
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SOURCE Austin Riggs Center
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