[Dynamic, long-term, and institutional psychotherapy to treat persistent depressive disorders].

BACKGROUND: Major depression is a public health problem that threatens to become the second leading cause of disability in the world. In this study we show the results obtained once we applied a psychodynamic psychotherapeutic and long-term process in patients with major depressive disorder, attending a public health institution (PHI).

METHODS: From a list of female volunteers, we randomly selected 30 patients who met the diagnostic criteria of major depression. They were divided into 5 groups, with 6 members each. Due to the high percentage of early desertions, we had to select from the very same list other 28 depressed women. In this framework there was not a full-time psychotherapist organizing and directing the psychotherapeutic process; the patients themselves were the ones who assumed such functions.

RESULTS: From the group of 58 patients, 26 completed the program scheduled. From this subgroup, 20 were responders and the rest, the other 6, non-responders. After the end of the psychotherapeutic process, the latter kept ingesting psychotropic drugs.

CONCLUSION: If we correct the mistakes made in this first opportunity and we implement new strategies, the psychotherapeutic process can be transformed into a more institutional tool. Psychotherapy directed only to the cases difficult to solve is significantly effective, safe, cheap, and it may achieve a wide coverage.