456 Short-term psychodynamic psychotherapies can benefit common mental disorders

May 05, 2015

written by Brian R McAvoy

Clinical question
How effective are short-term psychodynamic psychotherapies for common mental disorders?

Bottom line
There was a significantly greater improvement in the groups of people who received short-term psychodynamic psychotherapies (STPP) versus the control groups (wait-lists, treatment as usual or minimal treatment), both in the short term (<3 months after treatment) and medium term (3–6 months after treatment). These benefits generally appeared to increase in the long term. However, some results did not remain statistically significant in the long term. Although cost comparisons were not made in this review, it should be noted that these therapies were relatively short and much less expensive than long-term psychotherapy models. STPP might represent an economical approach to problems as complex as chronic pain, personality disorder, panic disorder, self-induced poisoning and other challenging-to-treat conditions.

Given the limited data, loss of significance in some measures at long-term follow-up and heterogeneity between studies, these findings should be interpreted with caution. Furthermore, variability in treatment delivery and treatment quality may limit the reliability of estimates of effect for STPP. Larger studies of higher quality and with specific diagnoses are warranted.

Common mental disorders include anxiety disorders, depressive disorders, stress-related physical conditions, certain behaviour disorders and personality disorders. Since the mid-1970s, STPP for a broad range of psychological and somatic disorders have been developed and studied. Early published meta-analyses of STPP, using different methods and samples, have yielded conflicting results, although some meta-analyses have consistently supported an empirical basis for STPP.

Cochrane Systematic Review
Abbass AA et al. Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Reviews, 2014, Issue 7. Art. No.: CD004687.DOI: 10.1002/14651858.CD004687.pub4. This review contains 33 studies involving 2173 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.