ABSTRACT
The combination of psychotherapy and pharmacotherapy in the treatment of affective disorders has attracted considerable attention in the past two decades [1]. However, it has obtained limited support from controlled trials [2,3]. Indeed, also a detrimental effect (exposure and alprazolam in panic disorder) has been reported [4]. The underlying assumption of the integrated approach was that of an additive model of interaction between pharmacotherapy and psychotherapy, which could take place on the basis of specific changes to be induced by specific treatments. Further, the simultaneous administration of pharmacotherapy and psychotherapy is based on a cross-sectional, flat view of the disorders which ignores their longitudinal development [5]. An alternative way of integrating pharmacotherapy and psychotherapy involves their sequential administration according to the stages of the disorder.
