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INFLUENTIAL PUBLICATIONS   |    
Long-Term Psychodynamic Psychotherapy in Complex Mental Disorders: Update of a Meta-Analysis
Falk Leichsenring; Sven Rabung
FOCUS 2014;12:336-346. doi:10.1176/appi.focus.12.3.336
Abstract

Background  Dose–effect relationship data suggest that short-term psychotherapy is insufficient for many patients with chronic distress or personality disorders (complex mental disorders).

Aims  To examine the comparative efficacy of long-term psychodynamic psychotherapy (LTPP) in complex mental disorders.

Method  We conducted a meta-analysis of controlled trials of LTPP fulfilling the following inclusion criteria: therapy lasting for at least a year or 50 sessions; active comparison conditions; prospective design; reliable and valid outcome measures; treatments terminated. Ten studies with 971 patients were included.

Results  Between-group effect sizes in favour of LTPP compared with less intensive (lower dose) forms of psychotherapy ranged between 0.44 and 0.68.

Conclusions  Results suggest that LTPP is superior to less intensive forms of psychotherapy in complex mental disorders. Further research on long-term psychotherapy is needed, not only for psychodynamic psychotherapy, but also for other therapies.
(Reprinted with permission from the British Journal of Psychiatry 2011;199:15–22) 

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Figure 1. Selection of Trials for Update of Authors’ 2008 Meta-Analysis of Long-Term Psychodynamic Psychotherapy (LTPP).16

Figure 2. Comparative Effects of Long-Term Psychodynamic Psychotherapy (LTPP) On Overall Outcome (Number of Patients in Analysis Sample May Differ From Intention-to-Treat Sample).
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Table 1.Comparison of Long-Term Psychodynamic Psychotherapy with Other Forms of Psychotherapy: Between-Group Effect Sizes
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ITT, intention to treat.

Table Footer Note

a Adjusted for ITT sample.

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b Unadjusted d.

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Table 2.Spearman Correlations of Outcome (Pre–Post Treatment Effect Sizes) with Duration of Therapy and Number of Treatment Sessions
Table Footer Note

LTPP, long-term psychodynamic psychotherapy.

Table Footer Note

a Insufficient data to calculate correlations.

Table Footer Note

*P < 0.05, **P < 0.01 (one-tailed).

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