Friday, December 01, 2006

Therapeutic Relationship and Bipolar Disorder Outcomes

In what seems a reasonably well-designed study in Psychiatry Research, researchers found that therapeutic alliance (quality of relationship between treating psychiatrist and patient) predicted manic symptoms six months after the relationship quality was measured. In other words, patients who reported good relationships with their docs at the start of the study tended to have reduced manic symptoms, even when controlling for the initial level of manic symptoms. This fits nicely with other research suggesting that docs should be trained in how to develop and maintain therapeutic relationships with their patients.

As the view of psychiatric disorders becomes increasingly skewed toward biology at the exclusion of other factors, research like this should help to remind clinicians and researchers that there is more to treatment than simple pill dispensation.

Let me rephrase. It would help remind them if they were to actually notice studies such as this, but, unfortunately, this study will likely be read by few whereas poorly designed, tell us next to nothing clinical trials such as the recent Risperdal for depression study that I wrote much about (here, here, and here) will be read by thousands of docs. He who controls the distribution of information (via reprints, speakers, continuing medical education, etc.) controls clinical practice.

2 comments:

Benedict 16th said...

Reminded me of an answer I got from a clinical psychiatrist once...

Q. Why are half of all Psychiatric workers* nuts**
A. Well if you went to medical school and you had had say a "congenital heart defect" then you would have been interested in heart anatomy and pathophysiology, and not always but quite possibly end up in a career in that area...

I only said 50% so he could mentally excuse himself...

Benedict







* Including psych nurses, an ex-g from way back, her mother was a psych nurse and she was definitely several sheets to the wind

** should be in the new DSM-V any day now

Marissa Miller said...

I don't know if my post originally showed up (dang stupid Blogger/Google account sign ins) but I said... ahem:

"In what seems a reasonably well-designed study in Psychiatry Research, researchers found that therapeutic alliance (quality of relationship between treating psychiatrist and patient) predicted manic symptoms six months after the relationship quality was measured. In other words, patients who reported good relationships with their docs at the start of the study tended to have reduced manic symptoms, even when controlling for the initial level of manic symptoms. This fits nicely with other research suggesting that docs should be trained in how to develop and maintain therapeutic relationships with their patients."

*sigh* This sounds too good to be true. If only I had a psychiatrist that I felt COMPLETELY comfortable with...