The efficacy of psychodynamic therapy is controversial. Previous meta-analyses
have reported discrepant results.
To test the efficacy of short-term psychodynamic psychotherapy (STPP)
in specific psychiatric disorders by performing a meta-analysis of more recent
studies. We assessed outcomes in target problems, general psychiatric symptoms,
and social functioning.
We identified studies of STPP published between January 1, 1970, and
September 30, 2004, by means of a computerized search using MEDLINE, PsycINFO,
and Current Contents. Rigorous inclusion criteria, included randomized controlled
trials, use of treatment manuals and ensurance of treatment integrity, therapists
experienced or specifically trained in STPP, treatment of patients with specific
psychiatric disorders, reliable and valid diagnostic measures, and data necessary
to calculate effect sizes. Studies of interpersonal therapy were excluded.
Seventeen studies fulfilled the inclusion criteria. The information was extracted
by 3 raters. Effect sizes were calculated for target problems, general psychiatric
symptoms, and social functioning using the data published in the original
studies. To examine the stability of outcome, we assessed effect sizes separately
for end of therapy and follow-up assessment. The effect sizes of STPP were
compared with those of waiting-list control patients, treatments as usual,
and other forms of psychotherapy.
Short-term psychodynamic psychotherapy yielded significant and large
pretreatment-posttreatment effect sizes for target problems (1.39), general
psychiatric symptoms (0.90), and social functioning (0.80). These effect sizes
were stable and tended to increase at follow-up (1.57, 0.95, and 1.19, respectively).
The effect sizes of STPP significantly exceeded those of waiting-list controls
and treatments as usual. No differences were found between STPP and other
forms of psychotherapy.
Short-term psychodynamic psychotherapy proved to be an effective treatment
in psychiatric disorders. However, further research of STPP in specific psychiatric
disorders is needed, including a study of the active ingredients of STPP.
Effectiveness studies should be included.