Do psychotherapies produce neurobiological effects?

Background: An area of recent interest in psychiatric research is the application of neuroimaging techniques to investigate neural events associated with the development and the treatment of symptoms in a number of psychiatric disorders. Objective: To examine whether psychological therapies modulate brain activity and, if so, to examine whether these changes similar to those found with relevant pharmacotherapy in various mental disorders. Methods: Relevant data were identified from Pubmed and Psyclnfo searches up to July 2005 using combinations of keywords including 'psychological therapy', 'behaviour therapy', 'depression', 'panic disorder', 'phobia', 'obsessive compulsive disorder', 'schizophrenia', 'psychosis', 'brain activity', 'brain metabolism', 'PET', 'SPECT' and 'fMRI'. Results: There was ample evidence to demonstrate that psychological therapies produce changes at the neural level. The data, for example in depression, panic disorder, phobia and obsessive compulsive disorder (OCD), clearly suggested that a change in patients' symptoms and maladaptive behaviour at the mind level with psychological techniques is accompanied with functional brain changes in relevant brain circuits. In many studies, cognitive therapies and drug therapies achieved therapeutic gains through the same neural pathways although the two forms of treatment may still have different mechanisms of action. Conclusions: Empirical research indicates a close association between the 'mind' and the 'brain' in showing that changes made at the mind level in a psychotherapeutic context produce changes at the brain level. The investigation of changes in neural activity with psychological therapies is a novel area which is likely to enhance our understanding of the mechanisms for therapeutic changes across a range of disorders.