title: Psychodynamic therapy meets evidence-based medicine: a systematic review using updated criteria.
abstract: Psychodynamic therapy (PDT) is an umbrella concept for treatments that operate on an interpretive-supportive continuum and is frequently used in clinical practice. The use of any form of psychotherapy should be supported by sufficient evidence. Efficacy research has been neglected in PDT for a long time. In this review, we describe methodological requirements for proofs of efficacy and summarise the evidence for use of PDT to treat mental health disorders. After specifying the requirements for superiority, non-inferiority, and equivalence trials, we did a systematic search using the following criteria: randomised controlled trial of PDT; use of treatment manuals or manual-like guidelines; use of reliable and valid measures for diagnosis and outcome; adults treated for specific mental problems. We identified 64 randomised controlled trials that provide evidence for the efficacy of PDT in common mental health disorders. Studies sufficiently powered to test for equivalence to established treatments did not find substantial differences in efficacy. These results were corroborated by several meta-analyses that suggest PDT is as efficacious as treatments established in efficacy. More randomised controlled trials are needed for some mental health disorders such as obsessive-compulsive disorder and post-traumatic stress disorder. Furthermore, more adequately powered equivalence trials are needed.
authors: Department of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany. Electronic address: falk.leichsenring@psycho.med.uni-giessen.de.
authors: Falk
authors: F
authors: Leichsenring
authors: Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium; Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK.
authors: Patrick
authors: P
authors: Luyten
authors: The Derner Institute of Advanced Psychological Studies, Adelphi University, NY, USA.
authors: Mark J
authors: MJ
authors: Hilsenroth
authors: Department of Psychiatry, Dalhousie University, Centre for Emotions and Health, Halifax, NS, Canada.
authors: Allan
authors: A
authors: Abbass
authors: The Derner Institute of Advanced Psychological Studies, Adelphi University, NY, USA.
authors: Jacques P
authors: JP
authors: Barber
authors: Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
authors: John R
authors: JR
authors: Keefe
authors: Department of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany.
authors: Frank
authors: F
authors: Leweke
authors: Department of Psychology, Alpen-Adria-Universität Klagenfurt, Klagenfurt, Austria; Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Sven
authors: S
authors: Rabung
authors: Department of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany.
authors: Christiane
authors: C
authors: Steinert
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D064889:Psychotherapy, Psychodynamic