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Neural effects of antidepressant medication and psychological treatments: a quantitative synthesis across three meta-analyses
- Source :
- The British Journal of Psychiatry
- Publication Year :
- 2021
- Publisher :
- Royal College of Psychiatrists, 2021.
-
Abstract
- BackgroundInfluential theories predict that antidepressant medication and psychological therapies evoke distinct neural changes.AimsTo test the convergence and divergence of antidepressant- and psychotherapy-evoked neural changes, and their overlap with the brain's affect network.MethodWe employed a quantitative synthesis of three meta-analyses (n = 4206). First, we assessed the common and distinct neural changes evoked by antidepressant medication and psychotherapy, by contrasting two comparable meta-analyses reporting the neural effects of these treatments. Both meta-analyses included patients with affective disorders, including major depressive disorder, generalised anxiety disorder and panic disorder. The majority were assessed using negative-valence tasks during neuroimaging. Next, we assessed whether the neural changes evoked by antidepressants and psychotherapy overlapped with the brain's affect network, using data from a third meta-analysis of affect-based neural activation.ResultsNeural changes from psychotherapy and antidepressant medication did not significantly converge on any region. Antidepressants evoked neural changes in the amygdala, whereas psychotherapy evoked anatomically distinct changes in the medial prefrontal cortex. Both psychotherapy- and antidepressant-related changes separately converged on regions of the affect network.ConclusionsThis supports the notion of treatment-specific brain effects of antidepressants and psychotherapy. Both treatments induce changes in the affect network, but our results suggest that their effects on affect processing occur via distinct proximal neurocognitive mechanisms of action.
- Subjects :
- Paper
Affect (psychology)
Amygdala
050105 experimental psychology
cognitive–behavioural therapies
03 medical and health sciences
0302 clinical medicine
anxiety disorders
Neuroimaging
Humans
Medicine
Academic Psychiatry
0501 psychology and cognitive sciences
skin and connective tissue diseases
Prefrontal cortex
Depressive Disorder, Major
Mood Disorders
business.industry
Panic disorder
05 social sciences
imaging
Antidepressants
medicine.disease
Antidepressive Agents
Psychotherapy
Psychiatry and Mental health
medicine.anatomical_structure
Major depressive disorder
Antidepressant
sense organs
depressive disorders
business
Neurocognitive
Neuroscience
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14721465 and 00071250
- Volume :
- 219
- Database :
- OpenAIRE
- Journal :
- The British Journal of Psychiatry
- Accession number :
- edsair.doi.dedup.....21b206a19b12669b39e4cf3f7d4def03