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A Meta-analysis

Falk Leichsenring, DSc; Sven Rabung, MSc; Eric Leibing, DSc

Arch Gen Psychiatry. 2004;61:1208-1216.

Background  The efficacy of psychodynamic therapy is controversial. Previous meta-analyses have reported discrepant results.

Objective  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.

Design  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.

Results  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.

Conclusions  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.

Author Affiliations: Clinic of Tiefenbrunn (Dr Leichsenring and Mr Rabung) and Department of Psychosomatics and Psychotherapy, University of Goettingen (Drs Leichsenring and Leibing), Goettingen, Germany.

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