Background and Objective: Transcranial direct current stimulation (tDCS) has shown therapeutic efficacy in different psychiatric disorders including depression, attention deficit hyperactivity disorder (ADHD), cognitive functions in healthy subjects have made this technique an interesting research option for developing non-medication techniques for a variety of psychiatric disorders. This paper aimed to comprehensively review the therapeutic applications of tDCS in psychiatric disorders. Method: The databases of PubMed (1985-2018), EMBASE (1985-2018), Web of Sciences (1985- 2018), PsycINFO (1980-2018) and Google Scholar (1980-2018) were searched using the search terms "transcranial direct current stimulation" OR "tDCS" AND "psychiatric disorders" OR “neuropsychiatric disorders” AND "treatment" AND “efficacy”. The retrieved records were screened for the title and abstract by two authors and the relevant papers were reviewed for further details. The applications of tDCS in the disorders with promising outcomes are discussed. Results: TDCS has shown therapeutic effects in different neuropsychiatric disorders such as major depression, attention deficit hyperactivity disorder (ADHD), schizophrenia, Alzheimer disease (AD), tinnitus, obsessive compulsive disorder, hallucinations, and substance abuse. The clinical efficacy for major depression, ADHD, schizophrenia, and tinnitus is more promising. This may be partly because more studies have been conducted on these disorders than the other disorders. For depression tDCS shows treatment efficacy comparable with the first generation antidepressive pharmacological drugs. Anodal tDCS over prefrontal cortex (PFC) was the most used protocol for major depression. The anodal tDCS over frontal cortex and right inferior frontal gyrus show promising therapeutic effects in ADHD. For tinnitus the most frequent used protocols are bifrontal and bilateral tDCS applied over dorsolateral PFC and auditory cortex. Anodal tDCS over frontal cortex particularly LDLPFC and temporal cortex showed therapeutic efficacy in AD. For schizophrenia, tDCS has shown effectiveness in reducing the disease’s symptoms ranging from auditory hallucinations which the effects were the most marked to working memory, learning, negative and cognitive symptoms. The frequently used sites of stimulation were PFC and temporal cortex. Conclusion: The current evidence showed the therapeutic efficacies of tDCS as adjunctive or alternative treatment option for different neuropsychiatric disorders. TDCS due to its safe and cost-effective profile could be developed for symptoms amelioration or at least cognitive enhancement in these disorders. However, further studies with big sample size should be conducted to develop effective protocol for each disorder as well as understanding the mechanisms of action of tDCS in neuropsychiatric disorders. Keywords: Transcranial direct current stimulation, neuropsychiatric disorders, treatment, depression, schizophrenia, ADHD, Alzheimer disease, tinnitus.
Background: Short-term dynamic psychotherapy is a well-established treatment modality. Habib Davanloo, MD was a pioneer in bringing it to the forefront of psychotherapy. Objective: The aim of this paper is to highlight Habib Davanloo’s unique contribution to the field of dynamic psychiatry and psychotherapy by tracing the development of his metapsychological theory of the unconscious, placing it in historical perspective. Method: The origin and development of dynamic psychiatry, from the early work of Mesmer through classical psychoanalysis and contemporary theories will be reviewed. Next, the movement aimed at shortening the course of psychotherapy while maintaining a psychodynamic perspective will be explored. Davanloo’s unique contributions to the field will be elaborated. The development of Davanloo’s metapsychology of the unconscious from his earliest work beginning in the 1960’s and further developed in his technique of “Unlocking the Unconscious” in the 1980’s will be examined. I will then turn to Davanloo’s work in the 1990’s and early 2000’s, which focused on widening the range of patients who could be successfully treated with his technique, and on expanding his training programs. Davanloo’s most recent work in the 2000’s and 2010’s involving Audiovisual Closed Circuit Training Workshops on the Mobilization of the Unconscious, Total Removal of Resistance and Multidimensional Unconscious Structural Change will be reviewed. Conclusion: Davanloo was indeed a pioneer in short-term psychotherapy. He remains at the cutting edge, continuing to shorten the course, increasing the depth and the range of this powerful treatment modality, and developing innovative teaching methods. Keywords: H. Davanloo, short-term dynamic psychotherapy, ISTDP, unlocking the unconscious, mobilization of the unconscious, unconscious structural change.
Background: Davanloo’s ISTDP has been the subject of much focus and attention. He has published extensively on his earlier work. But many of his newer theories and techniques, developed during the last decade in the Montreal Closed Circuit Training Program, have not been disseminated as widely as his original publications. These include his opinions and theories on transference neurosis (and its various presentations), intergenerational transference neurosis, and impairment in the unconscious defensive organization. Objective: This paper is the second of a two-article series on these newer concepts. The first paper focused on definitions and discussions of these concepts. This second paper will now focus on the application of these principles in a case seen in the private practice of one of the authors. Method: The authors have translated (from German into English) several vignettes from a therapeutic interview. The patient is a 17-year-old girl with anorexia nervosa and a complex unconscious. The psychotherapeutic techniques used in each vignette will be underscored and explained in subsequent analyses. Results: Davanloo’s newer principles and techniques will be illustrated and made easy to understand in the case of an adolescent with a complex unconscious. Conclusion: This case was reviewed at the 38th Annual Metapsychology Meeting in Montreal, Canada in October, 2017 and highlights the new discoveries and techniques of this psychotherapeutic modality. Keywords: Unconscious, anorexia nervosa, transference neurosis, intergenerational, ISTDP, Davanloo.
