Combination of psychotherapy and drugs in the treatment of neurosis.

Abstract

Eighty out-patients with neurotic disorders were studied in an integrated treatment model combining psychotherapy and psychotropics in a "conjoint marital therapy" setting. The spouses, who seemed a healthy group, were used as reporters, as controls and as participants in the psychotherapy. The pharmacological trial was a double-blind, cross-over study, comparing bromazepam and thioridazine after a placebo period. Bromazepam was more effective in controlling different anxiety symptoms and demonstrated more potent activating properties than thioridazine. Hostility symptoms, however, responded better to thioridazine. These findings were confirmed by ratings performed by patients, spouses and the investigator. Differences in drug preference and drop-out rate showed the same tendency. Nine weeks'' continuous treatment did not change the differences found in the cross-over study. No pharmacological rebound symptoms were observed after drug withdrawal. The personality of the spouses was related to the outcome in the patients. Moreover, there was an obvious positive interaction between the psychotherapy given and the drug treatment.