Article Review:
Integration of Care: Integrating Psychotherapy and Pharmacotherapy to Improve Outcomes among Patients with Mood Disorders
Introduction
Mental disorder is one of the common health problems nowadays. About 44 million Americans have experienced a mental disorder (Mood Disorders 2006). The most common mood disorders include major depression and bipolar disorder. Putting in figures to explain how common is the occurrence of these common mood disorders in the U.S., about 20% of the population reports at least one symptom of depression in a month, and about 12% reports two or more in a year (Factsheet: Mood Disorders 2007). The article written by Ripu D. Jindal, M.D. and Michael E. Thase, M.D. entitled: Integration of Care: Integrating Psychotherapy and Pharmacotherapy to Improve Outcomes among Patients with Mood Disorders, is about treatment for mood disorders. Equally important consideration when dealing with treatment for mood disorders is the cost of the treatment. In this article, the authors allow us to evaluate the cost of possible treatment methodology for mood disorders.
Summary
Psychosocial interventions, pharmacologic treatments, or the combination of these two is used as treatment in subgroups of patients with mood disorders. Combined treatment (both psychosocial and pharmacologic) is gaining acceptance among mental health professionals. The combined treatment is categorized into two—single provider and split-treatment model. The latter is being viewed by most community mental health professionals as the model that is cost effective. These findings are not concrete yet. Though combined treatment has promising advantages, future researches are still recommended.
Analysis
Mood disorder is believed by researchers to have caused by imbalances in the brain’s chemical activity and by environmental factors. Depression and bipolar disorder are most known mood disorders. Depression is persistent sadness over a long period of time, could be months to years. The National Institute for Mental Health states that about 3-4 million men citizens have experienced depression; while women citizens are affected twice as much as men. The common symptoms of depression are change in the sleeping pattern, loss of appetite, fatigue, frequent headache or stomachache, inability or concentrate, and persistent sadness. Bipolar disorder is commonly known as extreme mood swings. This disorder has the tendency to run in the family (Mood Disorders 2006). The common symptoms of bipolar disorder are loss of appetite, irritable moods, giving poor judgment, and increased energy.
People with mental disorder are being treated with psychotherapy. In layman’s terms, psychotherapy is simply talk therapy, counseling sessions, or psychosocial therapy. Under this treatment, the patients are being informed of their condition, the symptoms that go with the mental disorder, and the appropriate coping mechanism and stress management programs for them (Psychotherapy 2008). Pharmacologic treatment, or the use of appropriate medicine for the mental disorder, is another way of treating mental disorders. In the article, the use of placebo is being used to treat a mental disorder within an agreed time interval without interventions.
The article stressed that the cost of treating mental disorder is quite high. So the authors reexamined the treatments currently used to treat mental disorder and analyze as to what treatment would give the best desirable results at the most cost-effective way. The combination of psychotherapy and pharmacologic treatment has gained acceptance from a large group of mental health professionals. They believed that pharmacotherapy speed up patients’ recovery. With the combination of treatments, the notion that psychotherapy is the only solution to treating mental disorder is scrapped because the combined treatments have shown promising results for the patients.
Combined treatment is classified into single provider model and split-treatment model. The single-provider model refers to hiring the expertise of a psychiatrist or nurse practitioners. The split-treatment model refers to the collaboration between a psychotherapist and primary care physician. How do we lessen the cost of treatment? The split-treatment model is believed to be cost-effective than the single provider in the basis of the hourly fee of a psychiatrist and other mental health providers. According to the article, another way to make the cost effective is having the primary care physician handle pharmacotherapy or the prescribing of medicine.
Conclusion
The authors have established the importance of combining psychosocial interventions and pharmacotherapy for some patients. However, this combination is not the “set-on-the-stone” standard for treating all mental disorders. Further researches are needed in order to establish other effective methodologies in treating other forms of mental disorders.
The article has also established that psychosocial interventions are not the only treatment for mental disorders. Proper pharmacologic treatment is also applicable in order to give ease and comfort to the patients. The combined treatment is needed in order to meet the needs of the patient. In terms of the cost, combined treatment is also being viewed as cost-effective. This is not final yet. Researchers are still conducting studies in order to search for the most effective way of treating persons with mental disorders at the most reasonable price.
List of References
Bibbo, Kimberly (2008). Psychotherapy versus Pharmacotherapy: Is One Better than the Other? Serendip. [Internet]. Available from: http://serendip.brynmawr.edu/bb/neuro/neuro99/web2/Bibbo.html [Accessed 20 October 2008].
Factsheet: Mood Disorders (2007). The Mental Health America. [Internet]. Available from: http://www.nmha.org/index.cfm?objectId=C7DF8E29-1372-4D20-C818ABB0E8C14E4D [Accessed 20 October 2008].
Mood Disorders (2006). National Mental Health Information Center. [Internet]. Available from: http://mentalhealth.samhsa.gov/publications/allpubs/ken98-0049/default.asp [Accessed 20 October 2008].
Psychotherapy (2008). MayoClinic.com. [Internet]. Available from: http://www.mayoclinic.com/health/psychotherapy/MY00186/rss=1 [Accessed 20 October 2008].