Discussion
major depression, trauma
The findings of MODE will be relevant for both clinical and basic research in identifying the brain-based mechanisms whereby psychotherapy exerts its therapeutic effects. MODE is, to our knowledge, the first study to investigate the neurobiological changes in response the effects of intensive psychoanalytic psychotherapy. MODE will thus contribute to the methodology of using MRI studies in translational psychotherapy. MODE may be the first in a series of studies combining neurobiological, psychological, and psychoanalytical approaches. It will allow us to establish outcome measures on a neural level that are perhaps more sensitive in distinguishing the differential effects of therapeutic dosing than established behavioral and clinical markers of symptom severity and change can provide.MODE can also offer an answer to the question of why a relatively large group of patients with major depression respond poorly to treatment. Our initial studies suggest that these are patients who often suffered severe trauma before the age of 7 [This research has a notable strength in its randomized controlled design. Yoking MRI to RCTs can identify neurobiological mechanisms predicting and causally mediating treatment response [