title: Comparison of the neurobiological effects of attribution retraining group therapy with those of selective serotonin reuptake inhibitors.
abstract: The aim of this study was to compare the effectiveness of attribution retraining group therapy (ARGT) with selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). Subjects were sequentially recruited and randomized into two groups, one receiving ARGT (n = 63) and the other SSRIs (n = 66) for 8 weeks. Fifty-four ARGT outpatients with MDD (n = 19), GAD (n = 19), and OCD (n = 16) and 55 SSRI outpatients with MDD (n = 19), GAD (n = 19), and OCD (n = 17) completed the study. All subjects were assessed using the Hamilton Depression Scale and Hamilton Anxiety Scale before and after treatment. The 10-item Yale-Brown Obsessive Compulsive Scale was employed only for OCD subjects. Plasma levels of serotonin, norepinephrine, cortisol, and adrenocorticotropic hormone were also measured at baseline and 8 weeks after completion of treatment. Symptom scores were significantly reduced (P < 0.001) in both the ARGT and SSRI groups at the end of treatment. However, MDD, GAD and OCD patients in the ARGT group had significantly lower plasma cortisol concentrations compared to baseline (P < 0.05), whereas MDD and OCD patients receiving SSRIs showed significantly increased plasma levels of serotonin (P < 0.05). These findings suggest that ARGT may modulate plasma cortisol levels and affect the hypothalamus-pituitary-adrenal axis as opposed to SSRIs, which may up-regulate plasma serotonin levels via a different pathway to produce an overall improvement in the clinical condition of the patients.
authors.affiliation: Medical Psychology Department, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: N
authors.initials: N
authors.lastname: Zhang
authors.forename: Y L
authors.initials: YL
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Yang
authors.forename: T C
authors.initials: TC
authors.lastname: Timothy
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
references.citation: Psychoneuroendocrinology. 2004 Oct;29(9):1198-204
references.pmid: 15219644
references.citation: J Abnorm Psychol. 1978 Feb;87(1):49-74
references.pmid: 649856
references.citation: Biol Psychiatry. 1998 Aug 1;44(3):151-62
references.pmid: 9693387
references.citation: J Biomed Res. 2011 Sep;25(5):348-55
references.pmid: 23554710
references.citation: Eur Neuropsychopharmacol. 2008 Dec;18(12):917-24
references.pmid: 18805677
references.citation: Eur Neuropsychopharmacol. 1999 Jul;9 Suppl 3:S81-6
references.pmid: 10523062
references.citation: J Psychiatr Res. 2007 Dec;41(11):928-33
references.pmid: 17049559
references.citation: J Abnorm Psychol. 1993 Feb;102(1):101-9
references.pmid: 8436686
references.citation: J Endocrinol. 1999 Jan;160(1):1-12
references.pmid: 9854171
references.citation: J Anxiety Disord. 1997 Jan-Feb;11(1):1-16
references.pmid: 9131878
references.citation: Behav Res Ther. 1997 Aug;35(8):703-19
references.pmid: 9256514
references.citation: Arch Gen Psychiatry. 2005 Jun;62(6):668-75
references.pmid: 15939844
references.citation: Neuropsychobiology. 1992;26(4):182-5
references.pmid: 1299792
references.citation: Psychosom Med. 2000 May-Jun;62(3):304-8
references.pmid: 10845343
references.citation: Biol Psychiatry. 1998 Dec 15;44(12):1286-94
references.pmid: 9861471
references.citation: Arch Gen Psychiatry. 1989 Nov;46(11):1006-11
references.pmid: 2684084
references.citation: J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
references.pmid: 14399272
references.citation: Neurosci Lett. 2003 May 22;342(3):206-10
references.pmid: 12757900
references.citation: Br J Med Psychol. 1959;32(1):50-5
references.pmid: 13638508
references.citation: Mol Psychiatry. 2002;7(3):254-75
references.pmid: 11920153
references.citation: Stress. 2003 Sep;6(3):173-88
references.pmid: 13129811
references.citation: Biol Psychol. 1994 Mar;37(2):161-75
references.pmid: 8003591
references.citation: Horm Behav. 2003 Jan;43(1):60-6
references.pmid: 12614635
references.citation: Int J Neurosci. 2005 Dec;115(12):1711-20
references.pmid: 16287635
references.citation: Psychol Bull. 1985 Nov;98(3):495-512
references.pmid: 3909186
references.citation: J Affect Disord. 2005 Aug;87(2-3):305-11
references.pmid: 15951024