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Meganck R, Desmet M, Van Nieuwenhove K, De Smet M, Hennissen V, Truijens F, De Geest R, Hermans G, Bockting C, Norman UA, Loeys T, Inslegers R, Van den Abeele T, Baeken C, Vanheule S. The Ghent Psychotherapy Study: A Pragmatic, Stratified, Randomized Parallel Trial into the Differential Efficacy of Psychodynamic and Cognitive-Behavioral Interventions in Dependent and Self-Critical Depressive Patients. Psychother Psychosom 2023; 92:267-278. [PMID: 37562373 DOI: 10.1159/000531643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Different types of psychotherapy are effective for treating major depressive disorder across groups yet show large within-group differences. Patient personality style is considered a potentially useful variable for treatment matching. OBJECTIVE This study is the first experimental test of the interaction between therapeutic approach and patients' dependent versus self-critical personality styles. METHODS A pragmatic stratified parallel trial was carried out with 100 adult patients diagnosed with DSM-IV-TR major depressive disorder. They were randomly assigned to short-term (16-20 sessions) cognitive behavioral therapy (CBT) or short-term psychodynamic psychotherapy (STPP). Patients were assessed at baseline, during therapy, post-therapy, and at 3- and 6-month follow-up. Primary outcome is depression severity measured by the Hamilton Rating Scale for Depression posttreatment. Primary analysis was by intention to treat. This trial is registered with the ISRCTN registry (www.isrctn.com), number ISRCTN17130982. RESULTS The intention-to-treat sample consisted of 100 participants; 40 with self-critical and 60 with dependent personality styles were randomized to either CBT (n = 50) or STPP (n = 50). We observed no interaction effect (-0.34 [-6.14, 5.46]) between therapy and personality style and found no evidence for a difference in effectiveness between the treatments in general in terms of symptom reduction and maintained benefits at 6-month follow-up. CONCLUSION We found no evidence that dependent versus self-critical personality styles moderate the relation between treatment and outcome in depression. Research using individual patient data could gain further insight into why specific therapeutic approaches work better for specific patients.
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Affiliation(s)
- Reitske Meganck
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Gent, Belgium
| | - Mattias Desmet
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Gent, Belgium
| | | | - Melissa De Smet
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Gent, Belgium
| | - Vicky Hennissen
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Gent, Belgium
| | - Femke Truijens
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Rosa De Geest
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Gent, Belgium
| | - Goedele Hermans
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Gent, Belgium
| | - Claudi Bockting
- Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Tom Loeys
- Department of Data-analysis, Ghent University, Gent, Belgium
| | - Ruth Inslegers
- Department of Wellbeing and Society, OCMW, Antwerpen, Belgium
| | - Tim Van den Abeele
- Laboratory of Medical Biochemistry and Clinical Analysis, Ghent University, Gent, Belgium
| | - Chris Baeken
- Department of Head and Skin (UZGent), Ghent University, Gent, Belgium
| | - Stijn Vanheule
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Gent, Belgium
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Wienicke FJ, Beutel ME, Zwerenz R, Brähler E, Fonagy P, Luyten P, Constantinou M, Barber JP, McCarthy KS, Solomonov N, Cooper PJ, De Pascalis L, Johansson R, Andersson G, Lemma A, Town JM, Abbass AA, Ajilchi B, Connolly Gibbons MB, López-Rodríguez J, Villamil-Salcedo V, Maina G, Rosso G, Twisk JWR, Burk WJ, Spijker J, Cuijpers P, Driessen E. Efficacy and moderators of short-term psychodynamic psychotherapy for depression: A systematic review and meta-analysis of individual participant data. Clin Psychol Rev 2023; 101:102269. [PMID: 36958077 DOI: 10.1016/j.cpr.2023.102269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/04/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Short-term psychodynamic psychotherapy (STPP) is frequently used to treat depression, but it is unclear which patients might benefit specifically. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses and identify patient-level moderators. This IPD meta-analysis examined the efficacy and moderators of STPP for depression compared to control conditions. METHODS PubMed, PsycInfo, Embase, and Cochrane Library were searched September 1st, 2022, to identify randomized trials comparing STPP to control conditions for adults with depression. IPD were requested and analyzed using mixed-effects models. RESULTS IPD were obtained from 11 of the 13 (84.6%) studies identified (n = 771/837, 92.1%; mean age = 40.8, SD = 13.3; 79.3% female). STPP resulted in significantly lower depressive symptom levels than control conditions at post-treatment (d = -0.62, 95%CI [-0.76, -0.47], p < .001). At post-treatment, STPP was more efficacious for participants with longer rather than shorter current depressive episode durations. CONCLUSIONS These results support the evidence base of STPP for depression and indicate episode duration as an effect modifier. This moderator finding, however, is observational and requires prospective validation in future large-scale trials.
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Affiliation(s)
- Frederik J Wienicke
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany; Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Peter Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Patrick Luyten
- Department of Clinical, Educational and Health Psychology, University College London, London, UK; Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Matthew Constantinou
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Jacques P Barber
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY, USA
| | - Kevin S McCarthy
- Department of Psychology, Chestnut Hill College, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nili Solomonov
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Peter J Cooper
- School of Psychology and Clinical Language Science, University of Reading, Reading, UK
| | - Leonardo De Pascalis
- Department of Psychological Science, University of Liverpool, Liverpool, UK; Department of Psychology, University of Bologna, Bologna, Italy
| | - Robert Johansson
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Alessandra Lemma
- Anna Freud National Center for Children and Families, London, UK
| | - Joel M Town
- Center for Emotions & Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Allan A Abbass
- Center for Emotions & Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bita Ajilchi
- Department of Psychology, Faculty of Human Science, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mary Beth Connolly Gibbons
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Giuseppe Maina
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy; Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Gianluca Rosso
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy; Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - William J Burk
- Department of Developmental Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Jan Spijker
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands; Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ellen Driessen
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands; Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, the Netherlands
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Abbass A, Town J, Holmes H, Luyten P, Cooper A, Russell L, Lumley MA, Schubiner H, Allinson J, Bernier D, De Meulemeester C, Kroenke K, Kisely S. Short-Term Psychodynamic Psychotherapy for Functional Somatic Disorders: A Meta-Analysis of Randomized Controlled Trials. Psychother Psychosom 2021; 89:363-370. [PMID: 32428905 DOI: 10.1159/000507738] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 04/04/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Functionalsomatic disorders (FSD) are common and costly, thereby driving the need for the development of effective brief treatment options. Short-term psychodynamic psychotherapy (STPP) is one candidate treatment method. OBJECTIVE To review and meta-analyze, where possible, randomized controlled trials (RCTs) of STPP for FSD. METHODS Following a systematic search of the literature, we performed a meta-analysis of available RCT groups to determine the effects of STPP on a range of outcomes after treatment, and medium- and long-term follow-ups. RESULTS In meta-analyses of 17 RCTs, STPP significantly outperformed minimal treatment, treatment as usual, or waiting list controls on somatic symptom measures at all time frames, with small to large magnitude effect sizes. Descriptive reviews of 5 RCTs suggest that STPP performed at least as well as other bona fide psychological therapies. Limitations of this meta-analysis include small samples of studies and possible publication bias. CONCLUSIONS STPP is a valid treatment option for diverse FSD conditions resulting in somatic symptom reductions that persist over time. STPP should be included in FSD treatment guidelines.
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Affiliation(s)
- Allan Abbass
- Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada,
| | - Joel Town
- Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hannah Holmes
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Patrick Luyten
- University of Leuven, Leuven, Belgium.,University College London, London, United Kingdom
| | - Angela Cooper
- Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Leo Russell
- Devon Partnership NHS Trust, Devon, United Kingdom
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Howard Schubiner
- Ascension Providence Hospital and Michigan State University College of Human Medicine, Southfield, Michigan, USA
| | | | - Denise Bernier
- Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Kurt Kroenke
- Indiana University and Regenstrief Institute, Indianapolis, Indiana, USA
| | - Steve Kisely
- Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada.,University of Queensland, Woolloongabba, Queensland, Australia
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Abbass A, Lumley MA, Town J, Holmes H, Luyten P, Cooper A, Russell L, Schubiner H, De Meulemeester C, Kisely S. Short-term psychodynamic psychotherapy for functional somatic disorders: A systematic review and meta-analysis of within-treatment effects. J Psychosom Res 2021; 145:110473. [PMID: 33814192 DOI: 10.1016/j.jpsychores.2021.110473] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE A recent meta-analysis of 17 randomized, controlled trials (RCTs) showed that Short-term Psychodynamic Psychotherapy (STPP) for functional somatic disorders (FSD) reduced somatic symptoms compared to wait list, minimal treatment, and treatment-as-usual controls. A clinically important yet unanswered question is how much improvement patients experience within STPP treatment. METHODS Following a systematic search, we identified STPP trials presenting data at baseline and post-treatment/follow-up. Meta-analyses determined the magnitude of changes in somatic symptoms and other outcomes from before to after STPP, and analyses examined effect sizes as a function of study, therapy, and patient variables. RESULTS We identified 37 trials (22 pre-post studies and 15 RCTs) totaling 2094 patients treated an average of 13.34 sessions for a range of FSD. Across all studies, somatic symptoms improved significantly from pre-treatment to short-term follow-up with a large effect size (SMD = -1.07), which was maintained at long-term follow-up (SMD = -0.90). After excluding two outlier studies, effects at short- and medium-term follow-up remained significant but were somewhat reduced in magnitude (e.g., short-term SMD = -0.73). Secondary outcomes including anxiety, depression, disability, and interpersonal problems had medium to large effects. Effects were larger for studies of STPP that were longer than 12 sessions or used an emotion-focused type of STPP, and for chronic pain or gastrointestinal conditions than for functional neurological disorders. CONCLUSIONS STPP results in moderate to large improvements in multiple outcome domains that are sustained in long-term follow-up. STPP is an effective treatment option for FSD and should be included in treatment guidelines.
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Orvati Aziz M, Mehrinejad SA, Hashemian K, Paivastegar M. Integrative therapy ( short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial. Complement Ther Clin Pract 2020; 39:101122. [PMID: 32379661 DOI: 10.1016/j.ctcp.2020.101122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND and purpose: Cognitive-behavioral therapy and psychodynamic psychotherapy are common psychotherapies used for mental disorders. The purpose of the present article was to achieve an integration of cognitive-behavioral therapy and short-term psychodynamic psychotherapy that enjoys simultaneously the effects of cognitive-behavioral therapies and the stability of short-term psychodynamic psychotherapies. MATERIALS AND METHODS It was a pre-test/post-test experimental study. Selected based on a purposive non-probabilistic sampling method, the sample studied here consisted of 36 people diagnosed with generalized anxiety according to Clinical Diagnostic Interview, psychiatrist diagnosis and Hamilton Rating Scale for Anxiety (HRSA). They were divided randomly into three 12 person groups: two treated groups by integrative therapy and cognitive-behavioral therapy, and one control group. Only pre-test and post-test were employed for the control group without any kind of treatment. To select patients and evaluate the effects of each type of treatments, the "Hamilton Rating Scale for Anxiety" and "Beck Depression Inventory" were applied for the pre-test/post-test and the differential diagnosis, respectively. The results obtained were analyzed by covariance and ANOVA analyses using SPSS software. RESULTS The results of the study indicate the efficacy of both cognitive-behavioral therapy and integrative therapy in the treatment of generalized anxiety and integrative therapy was more effective in the treatment of generalized anxiety compared to cognitive-behavioral therapy. CONCLUSION Integrative treatment not only to be effective in the treatment of generalized anxiety disorder and the reduction of its symptoms, but also to be more effective than cognitive-behavioral therapy.
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Affiliation(s)
- Marzieh Orvati Aziz
- Faculty of Psychology and Educational Sciences, Alzahra University, Tehran, Iran.
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Tanzilli A, Majorana M, Fonzi L, Pallagrosi M, Picardi A, Fornari MACD, Biondi M, Lingiardi V. Relational variables in short-term psychodynamic psychotherapy: an effectiveness study. Res Psychother 2018; 21:327. [PMID: 32913770 PMCID: PMC7451296 DOI: 10.4081/ripppo.2018.327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/16/2018] [Indexed: 11/23/2022]
Abstract
This study examined associations between specific elements of therapeutic relationships and short-term psychodynamic psychotherapy (STPP) outcomes. Notably, we focused on therapists' subjective experiences during their first clinical interaction with patients, countertransference patterns and therapeutic alliance evaluated early in treatment, in relation to patient symptom changes at the end of STPP. Twenty clinicians completed the Comprehensive Psychopathological Rating Scale to evaluate patients' (N=32) symptom severity at the beginning and end of STPP. They also completed the Assessment of Clinicians' Subjective Experience (ACSE) to assess their subjective experiences of their patients at the first clinical interview and the Therapist Response Questionnaire (TRQ) and Working Alliance Inventory to evaluate their countertransference reactions and therapeutic alliance at the sixth therapy session. The findings showed that the TRQ and ACSE scales correlated in a coherent way, with the exception of the TRQ helpless/inadequate pattern and ACSE impotence. Strong and more negative TRQ countertransference patterns and ACSE dimensions were significantly associated with lower quality of the therapeutic alliance. Finally, better STPP outcomes were positively associated with a good therapeutic alliance and negatively correlated with greater difficulty in attunement at the beginning of clinical assessment and therapists' stronger responses of helplessness, frustration, and disengagement during therapy. These results confirm the precious value of the clinical relationship, which represents a useful source of information for therapists when planning therapeutic interventions.
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Affiliation(s)
- Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome
| | - Michele Majorana
- Department of Neurology and Psychiatry, Sapienza University of Rome
| | - Laura Fonzi
- Department of Neurology and Psychiatry, Sapienza University of Rome
| | - Mauro Pallagrosi
- Department of Neurology and Psychiatry, Sapienza University of Rome
| | - Angelo Picardi
- Centre of Behavioral Sciences and Mental Health, Italian National Institute of Health, Rome, Italy
| | | | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome
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Meganck R, Desmet M, Bockting C, Inslegers R, Truijens F, De Smet M, De Geest R, Van Nieuwenhove K, Hennissen V, Hermans G, Loeys T, Norman UA, Baeken C, Vanheule S. The Ghent Psychotherapy Study (GPS) on the differential efficacy of supportive-expressive and cognitive behavioral interventions in dependent and self-critical depressive patients: study protocol for a randomized controlled trial. Trials 2017; 18:126. [PMID: 28292331 PMCID: PMC5351275 DOI: 10.1186/s13063-017-1867-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/27/2017] [Indexed: 12/04/2022] Open
Abstract
Background Major depressive disorder is a leading cause of disease burden worldwide, indicating the importance of effective therapies. Outcome studies have shown overall efficacy of different types of psychotherapy across groups, yet large variability within groups. Although patient characteristics are considered crucial in understanding outcome, they have received limited research attention. This trial aims at investigating the interaction between therapeutic approach (pre-structured versus explorative) and the personality style of patients (dependent versus self-critical), which is considered a core underlying dimension of depressive pathology. Methods/design This study is a pragmatic stratified (dependent and self-critical patients) parallel trial with equal randomization (allocation 1:1) conducted in Flanders, Belgium. One hundred and four patients will be recruited and randomized to either 16–20 sessions of cognitive behavioral therapy for depression (pre-structured approach) or 16–20 sessions of short-term psychodynamic psychotherapy for depression (explorative approach) conducted by trained psychotherapists in private practices. The primary outcome is the severity of depression as measured by the Hamilton Rating Scale for Depression at completion of therapy. Secondary outcome measures include self-reported depressive and other symptoms, interpersonal functioning, idiosyncratic complaints, and the presence of the diagnosis of depression. Additional measures include biological measures, narrative material (sessions, interviews), and health care costs. Discussion This trial presents the test of an often-described, yet hardly investigated interaction between important personality dimensions and therapeutic approach in the treatment of depression. Results could inform therapists on how to match psychotherapeutic treatments to specific personality characteristics of their patients. Trial registration Isrctn.com, ISRCTN17130982. Registered on 2 February 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1867-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Reitske Meganck
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium.
| | - Mattias Desmet
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Claudi Bockting
- Department of Clinical Psychology, Social and Behavioral Sciences, Universiteit Utrecht, Heidelberglaan 1, Utrecht, 3584 CS, Netherlands
| | - Ruth Inslegers
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Femke Truijens
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Melissa De Smet
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Rosa De Geest
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Kimberly Van Nieuwenhove
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Vicky Hennissen
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Goedele Hermans
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Tom Loeys
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 1, Ghent, 9000, Belgium
| | - Ufuoma Angelica Norman
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, K12, Ghent, 9000, Belgium
| | - Stijn Vanheule
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
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Driessen E, Hegelmaier LM, Abbass AA, Barber JP, Dekker JJM, Van HL, Jansma EP, Cuijpers P. The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis update. Clin Psychol Rev 2015; 42:1-15. [PMID: 26281018 DOI: 10.1016/j.cpr.2015.07.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 04/08/2015] [Accepted: 07/30/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The efficacy of short-term psychodynamic psychotherapy (STPP) for depression is debated. Recently, a number of large-scale and high-quality studies have been conducted. We examined the efficacy of STPP by updating our 2010 meta-analysis. RESULTS After a thorough literature search, 54 studies (33 randomized clinical trials) totaling 3946 subjects were included. STPP was significantly more effective than control conditions at post-treatment on depression, general psychopathology and quality of life measures (d=0.49 to 0.69). STPP pre-treatment to post-treatment changes (d=0.57 to 1.18) indicated significant improvements on all outcome measures, which either significantly improved further (d=0.20 to 1.04) or were maintained from post-treatment to follow-up. No significant differences were found between individual STPP and other psychotherapies at post-treatment (d=-0.14) and follow-up (d=-0.06) in analyses that were adequately powered to detect a clinically relevant difference. STPP was significantly more efficacious than other psychotherapies on anxiety measures at both post-treatment (d=0.35) and follow-up (d=0.76). CONCLUSION We found clear indications that STPP is effective in the treatment of depression in adults. Although more high-quality studies are needed, particularly to assess the efficacy of STPP compared to control conditions at follow-up and to antidepressants, these findings add to the evidence-base of STPP for depression.
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Affiliation(s)
- Ellen Driessen
- VU University Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands.
| | - Lisa M Hegelmaier
- VU University Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands
| | - Allan A Abbass
- Dalhousie University, Centre for Emotions and Health, Halifax, NS, Canada
| | - Jacques P Barber
- Adelphi University, The Derner Institute of Advanced Psychological Studies, NY, USA
| | - Jack J M Dekker
- VU University Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands; Arkin Mental Health Care, Amsterdam, The Netherlands
| | | | - Elise P Jansma
- VU University Amsterdam, University Library, Amsterdam, The Netherlands
| | - Pim Cuijpers
- VU University Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands
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