Biomedical Therapies

Two types of therapy are psychotherapy and biomedical therapy. Both types of treatment help people with psychological disorders such as depression, anxiety, and schizophrenia. Psychotherapy is a psychological treatment that employs various methods to help someone overcome personal problems, or to attain personal growth. Biomedical therapy involves medication and/or medical procedures to treat psychological disorders.

Biomedical therapies approach psychological disorders as having biological causes and focus on eliminating or alleviating symptoms of psychological disorders. The mind and body are viewed as connected; poor physical health leads to poor mental health, and vice versa. 

Biomedical therapies and psychotherapy are often used in conjunction with one another to treat the whole person. Not all individuals will require biomedical therapy; however, for some, biomedical approaches can help enhance the effectiveness of psychotherapeutic approaches. For example, an individual with schizophrenia who is bombarded with visual or auditory hallucinations may find it difficult to focus in psychotherapy; with medication, the individual's hallucinations can be eliminated or reduced to a level that allows the individual to benefit from psychotherapy. 

Types of Biomedical Therapies

Pharmacotherapy

"Pharmacotherapy" refers to the use of medications in biomedical treatment. Medications exist in four classes: antipsychotics, antidepressants, anti-cycling agents, and hypnoanxiolytics. In general, the effectiveness of medications is upwards of 80%, but some of the medications also contain serious side effects. Once the medication is discontinued, symptoms often return; however, prolonged use can lead to other problems.

Different types and classes of medications are prescribed for different disorders. A depressed person might be given an antidepressant, a bipolar individual might be given a mood stabilizer, and a schizophrenic individual might be given an antipsychotic. These medications treat the symptoms of a psychological disorder; they can help people feel better so that they can function on a daily basis, but they do not cure the disorder. Some people may only need to take a psychotropic medication for a short period of time. Others, with severe disorders like bipolar disorder or schizophrenia, may need to take psychotropic medication continuously for effective symptom management.

Antidepressants

Biomedical therapies, such as the use of the antidepressant Zoloft, can be effective in reducing the symptoms of individuals with certain mental illnesses so that psychotherapeutic interventions can be more effective.

ECT

Another biologically based treatment that continues to be used, although infrequently, is electroconvulsive therapy (ECT; formerly known by the unscientific name "electroshock therapy"). It involves using an electrical current to induce seizures in the brain in order to help alleviate the effects of certain mental conditions, such as severe forms of depression or bipolar disorder. The exact mechanism is unknown, although it does help alleviate symptoms for people with severe depression who have not responded to traditional drug therapy (Pagnin, de Queiroz, Pini, & Cassano, 2004). About 85% of people treated with ECT improve (Reti, n.d.). However, the memory loss associated with repeated administrations has led to it typically being implemented as a last resort (Donahue, 2000; Prudic, Peyser, & Sackeim, 2000). A more recent alternative to ECT is transcranial magnetic stimulation (TMS), a procedure approved by the FDA in 2008 that uses magnetic fields to stimulate nerve cells in the brain to improve depression symptoms; like ECT, it is used when other treatments have not worked (Mayo Clinic, 2012).

Psychosurgery

Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental illness. Psychosurgery has always been a controversial medical field. Some countries have abandoned psychosurgery altogether; in others (the US and the UK, for example) it is only used in a few centers on small numbers of people with depression or obsessive-compulsive disorder (OCD). In some countries it is also used in the treatment of schizophrenia and other disorders.

Psychosurgery is a collaboration between psychiatrists and neurosurgeons. During the operation, which is carried out under a general anesthetic, a small piece of brain is destroyed or removed. The most common types of psychosurgery in current or recent use are capsulotomy, cingulotomy, subcaudate tractotomy, and limbic leucotomy. About a third of patients show significant improvement in their symptoms after the operation. Advances in surgical technique have greatly reduced the incidence of death and serious damage from psychosurgery; the remaining risks include seizures, incontinence, decreased drive and initiative, weight gain, and cognitive and affective problems.

Efficacy

Two ways in which biological therapies are studied are through efficacy research and effectiveness studies. Placebo-controlled randomized clinical trials, using strict exclusionary criteria when selecting subjects, have traditionally been used to study a psychiatric medication's efficacy (i.e., the ability of the medication to treat the condition better than placebo under controlled conditions). For example, studies comparing an antidepressant to a placebo may use an eight-week double-blind parallel design and include subjects with major depression, but without any other medical or psychiatric comorbidities. 

Effectiveness studies, on the other hand, are often larger, naturalistic studies that attempt to approximate "real-world" conditions by studying patients who may have psychiatric and medical comorbidities and by relying on broader outcome measures for assessing response. These studies may compare outcomes of treatment with multiple medications. Effectiveness studies are complementary to understanding drug efficacy.