Efficacy and moderators of short-term psychodynamic psychotherapy for depression: A systematic review and meta-analysis of individual participant data. (April 2023)

• Record Type: Journal Article
• Authors: Wienicke, Frederik J.; Beutel, Manfred E.; Zwerenz, Rüdiger; Brähler, Elmar; Fonagy, Peter; Luyten, Patrick; Constantinou, Matthew; Barber, Jacques P.; McCarthy, Kevin S.; Solomonov, Nili; Cooper, Peter J.; De Pascalis, Leonardo; Johansson, Robert; Andersson, Gerhard; Lemma, Alessandra; Town, Joel M.; Abbass, Allan A.; Ajilchi, Bita; Connolly Gibbons, Mary Beth; López-Rodríguez, Jaime; Villamil-Salcedo, Valerio; Maina, Giuseppe; Rosso, Gianluca; Twisk, Jos W.R.; Burk, William J.; Spijker, Jan; Cuijpers, Pim; Driessen, Ellen
• Is Part Of: Clinical psychology review. Volume 101(2023)
• Publication Date: 2023-04
• Subjects: Depression -- Efficacy -- Outcome -- Moderators -- Short-term psychodynamic psychotherapy -- Individual participant data Meta-analysis; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2023.102269
• Languages: English
• ISSNs: 0272-7358

Abstract

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. Highlights: Short-term psychodynamic psychotherapy (STPP) is a treatment for depression. STPP is superior to control conditions in decreasing depressive symptoms. Depressive episode duration might moderate STPP outcome.