Effectiveness of short-term psychodynamic group therapy in a public outpatient psychotherapy unit.
BACKGROUND
Short-term psychodynamic group therapy in heterogeneous patient groups is common in the public Danish psychiatric system but is in need of evaluation.


OBJECTIVE
To investigate improvement in 39-session psychodynamic group therapy using three criteria: 1) effect size (Cohen's d), 2) statistically reliable improvement, and 3) clinical significant change (CSC).


METHODS
Pre-post treatment naturalistic design based on 236 outpatients with diagnoses of mood (9.7%), neurotic (50.8%), and personality disorders (39.4%). Symptom change was evaluated on the SCL-90-R Global Severity Index (GSI) and subscales. Analyses were conducted on the total sample and after exclusion of 32 GSI pre-treatment no-cases.


RESULTS
The total sample GSI effect size was 0.74 indicating a moderate to large effect size (ranging from 0.67 in depressed to 0.74 in neurotic and personality disorder patients), which increased to 1.02 after exclusion of pre-treatment no-cases (ranging from 0.98 to 1.11 in depressed and personality disorder patients, respectively). However, in the GSI pre-treatment case sample, 43.1% were unchanged or deteriorated, 27% reliably improved and 29.9% obtained CSC status (ranging from 23.8% of the neurotic to 42.9% of the depressed patients).


CONCLUSIONS
Short-term psychodynamic group therapy is associated with medium to large or large effect sizes. However, even though many of the patients reliably improve, a substantial part of the patients are still, after therapy, within the pathological range compared with Danish norms.


CONCLUSIONS
Patients referred to public outpatient treatment settings may need alternative or longer treatment than 39 sessions of psychodynamic group therapy over 3 months.
Jensen
Hans Henrik
HH
Department of Environmental Health, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark. H.H.Jensen@pubhealth.ku.dk
Mortensen
Erik Lykke
EL
Lotz
Martin
M
D000328:Adult; D000553:Ambulatory Care; D003155:Community Mental Health Centers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D009497:Neurotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011575:Psychoanalytic Therapy / Q000379:methods*; D011594:Psychometrics; D011614:Psychotherapy, Brief / Q000379:methods*; D016896:Treatment Outcome