There are any number of alternative therapies for mental disorders that could be explored. Anatomy of an Epidemic focuses on two programs that have a proven track record of providing superior results.
A. Open Dialogue Therapy in Western Lapland for Psychotic Patients
In the Western World, Western Lapland in Finland has adopted a form of care for its psychotic patients that has produced astonishingly good long-term outcomes. At the end of two and five years, eighty percent of first-episode psychotic patients in Western Lapland are either employed or back at school. Only about one third of the patients are ever exposed to antipsychotic medications, and only 20% end up taking the drugs on a continual basis.
1. Two-Year Outcome in First Episode Psychosis Treated According to an Integrated Model. Is Immediate Neuroleptisation Always Needed? Lehtinen, V. European Psychiatry 15 (2000):312-320.
In this six-center study by Finnish investigators, 43% of the patients in the three experimental groups didn’t receive any antipsychotic medication, and overall, the outcomes for the experimental group “was equal or even somewhat better” than those treated conventionally with drugs. Western Lapland was one of the three experimental sites in this study.
2. Five-Year Experience of First-Episode Nonaffective Psychosis in Open-Dialogue Approach. Seikkula, J. Psychotherapy Research 16 (2006):214-228.
In this study of open-dialogue therapy in Western Lapland, at the end of five years 82% of the patients did not have psychotic symptoms, 86% had returned to their studies or were working, and only 14% were on a disability allowance. Only 29% of the patients had ever been exposed to an antipsychotic drug during the five years, and only 17% were on antipsychotics at the end of the study.
3. The Open Dialogue Approach to Acute Psychosis. Seikkula, J. Family Process 42 (2003):403-18.
A review article about open-dialogue therapy.
B. Exercise for Depression
4. Effects of exercise training on older patients with major depression . Blumenthal, J. Archives of Internal Medicine 159 (1999):2349-56.
In this Duke University study, older depressed patients were treated either exercise alone, exercise plus Zoloft, or Zoloft alone, and at the of 16 weeks, those treated with exercise alone were doing as well as the other two groups.
5. Exercise treatment for major depression. Babyak, M. Psychosomatic Medicine 62 (2000):633-8.
In the Duke study (above), at the end of ten months, the exercise-alone patients had a much better stay-well rate than either of the other two groups.
6. Benefits from aerobic exercise in patients with depression. British Journal of Sports Medicine 35 (2001):114-7.
7. A randomized, controlled study on the effects of a short-term endurance training programme in patients with major depression. Knubben, K. British Journal of Sports Medicine 41 (2007):29-33.
8. Physical activity, exercise, depression and anxiety disorders. Strohle, A. Journal of Neural Transmission 116 (2009):777-84.
These three studies (and others) have shown that exercise produces a “substantial improvement” within six weeks; that its effect size is “large;” and that 70% of all depressed patient respond to an exercise program.
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