SEMINAR: CWR Presents:

Systemic psychotherapy considers families and couples as systems, which are much more than each member composing them. The efficacy of this type of psychotherapy has been demonstrated around the world since the seventies.

The fundaments are focused in relationships, circularity and neutrality. In the last ten years intra-psychic elements has been rescued and techniques has been reported in order to perform individual systemic psychotherapy. This means that the person is treated with strategies supported by second order cybernetic, constructivist and narrative views without diminishing transactional influences.

Major depression is a disorder characterized by pathological sadness and anhedonia (difficulty of enjoyment), with well-documented biological alterations, but also related to affective nutrition in the family and in the society with consequences for the potentially depressed subject. Hypothesis of depression are complementary and include genetics, monoamines, hormones, neurotrofic factors, circadian rhythms, immunological elements, chronic stress, and inter-personal dysfunction. The objective of this work was to evaluate the response of subjects presenting a major depressive episode treated in an integral manner: with antidepressants and with individual systemic interventions.

Twenty patients were diagnosed using international approved criteria, antidepressant treatment was initiated and psychotherapy sessions were scheduled. Scales and inventories were used to determine severity of depression, quality of life, disability, clinical global impression, family functioning, and social performance.

Ten patients had remission of symptoms, although all of them responded to the integral treatment, as assessed with appropriate scale for depression. The protocol of the study lasted fourteen weeks including twelve to eighteen sessions. Patients presenting remission were those who could solve difficulties in their transactions. Responders without remission remained with relationship problems and continue in treatment for longer period than protocol timeframe. Attention was open for all of them at the end of the research. The psychotherapeutic work consisted in parameters for satisfactory communication, elements for discussion with absent members, positive reframing, and resize life with new narrative. Severity of depression was positive and significantly correlated with quality of life, disability, and family-social relations.

These are evidences supporting the effectiveness of integral treatment for improvement depression. In addition, the lack of resolutions of dysfunctional transactions is in accordance to the permanence of residual symptoms, which deteriorates global life, internal and external, and impairs enjoyment in a long term.

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