[Dynamic, long-term, and institutional psychotherapy to treat persistent depressive disorders]

Major depression is a public health problem that threatens to become the second leading cause of disability in the world. In this study we show the results obtained once we applied a psychodynamic psychotherapeutic and long-term process in patients with major depressive disorder, attending a public health institution (PHI).

From a list of female volunteers, we randomly selected 30 patients who met the diagnostic criteria of major depression. They were divided into 5 groups, with 6 members each. Due to the high percentage of early desertions, we had to select from the very same list other 28 depressed women. In this framework there was not a full-time psychotherapist organizing and directing the psychotherapeutic process; the patients themselves were the ones who assumed such functions.

From the group of 58 patients, 26 completed the program scheduled. From this subgroup, 20 were responders and the rest, the other 6, non-responders. After the end of the psychotherapeutic process, the latter kept ingesting psychotropic drugs.

If we correct the mistakes made in this first opportunity and we implement new strategies, the psychotherapeutic process can be transformed into a more institutional tool. Psychotherapy directed only to the cases difficult to solve is significantly effective, safe, cheap, and it may achieve a wide coverage.