Short-Term Psychodynamic Psychotherapy for Depression: For Whom Does It Work? A Research Perspective

Efficacy of short-term psychodynamic psychotherapy (STPP) in depressive disorders: A systematic review and meta-analysis

INTRODUCTION

Depression is one of the leading diseases globally. It can severely interfere with daily and occupational functioning of people affected. Both pharmacological interventions and psychotherapy are used for adult depression. The aim of the review is to evaluate the efficacy of short-term psychodynamic psychotherapy (STPP) by comparing STPP with different types of interventions.

MATERIALS AND METHODS

A systematic review with meta-analysis on the efficacy of STPP in depressive disorders was performed.

RESULTS

Meta-analysis findings confirm the superiority of STPP versus no interventions. The average effect size of depressive symptoms severity at the end of the treatment is -0.91 (95% CI: -1.49 - -0.33) in favor of STPP, while for clinical improvement of depressive symptoms is -0.78 (95% CI: -1.56 - 0.01). Results confirm a clear superiority of STPP to usual treatments unstructured. A mild superiority of efficacy of STPP on support psychotherapy emerged. Comparison of the efficacy of STPP vs cognitive-behavioral psychotherapy (CBT) shows little superior in case of STPP. No substantial differences in efficacy in case of STPP than control interventions emerged. Antidepressant therapy is resulted to be slightly more effective to STPP.

DISCUSSION

While all the other results confirm current literature, this review shows no superiority of combined treatment than STPP only.

LIMITATIONS

The review has some limitations such as the lack of moderation analysis and the high heterogenicity of the type of the studies.

CONCLUSIONS

The results confirm the efficacy of STPP in depressive disorders and endorse the guidelines of National Institute for Health and Clinical Excellence (NICE).

Comparing Psychoanalytic Process in Consulting Room and Teleconference: A Naturally Occurring Controlled Experiment

BACKGROUND

In response to COVID-19, clinicians migrated psychoanalyses to videoconference platforms, creating an opportunity for a controlled empirical study in which only the site varied.

HYPOTHESES

There will be no differences in the quality of the psychoanalytic process (QAP) in the consulting room (CR) and in videoconference (VC). Individuals' defensive functioning (adaptive style) will be associated with their capacity to maintain the analytic process when treatment moves from CR to VC. Underlying was the concept that empirical research of clinical psychoanalysis is possible.

PARTICIPANTS AND METHODS

Forty psychoanalysts of all ranks in the Accreditation Council for Psychoanalytic Education, Inc., accredited programs contributed 50 cases. Participants scored QAP at each site on a 0-to-100 scale. They reported patients' characteristic defense mechanisms using the Defensive Functioning Scale (DFS).

DATA ANALYSIS

To minimize bias, investigators calculated median DFS scores from data provided by clinicians. They compared QAP scores in CR and VC for the entire group without and with DFS scores, and for each DFS level (when feasible) using the related-samples Wilcoxon signed-rank test.

FINDINGS

There was no difference in QAP between CR and VC for the group as a whole; but QAP of the Minor Image Distorting group degraded significantly from CR to VC. This was the only group showing a significant difference.

CONCLUSIONS

While statistical significance may not reflect clinical significance, individual differences in adaptation to telepsychoanalysis warrant further study. Empirical research of phenomena occurring naturally in clinical psychoanalysis appears feasible.