Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up

Knekt, Paul; Lindfors, Olavi; Härkänen, Tommi; Välikoski, Maarit; Virtala, Esa; Laaksonen, Maarit A.; Marttunen, Mauri; Kaipainen, Markku; Renlund, Camilla

doi:10.1017/s003329170700164x

Cited by 226 publications

(205 citation statements)

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“…Although the limited studies of treatment of depression with psychodynamic psychotherapy have shown promising results (Churchill 2001;Leichsenring 2001;Abbass 2006;Knekt 2008), further research will help to clarify the role this approach can best play in treatment of depression and conflicted anger. In psychodynamic approaches to 5 depression: it is essential that the therapist responds to the a patient's anger in a non-judgemental manner the therapist criticises the patient's anger, to b reduce it with negative feedback the therapist ignores any expression or fantasy c of anger that the patient shows towards them the therapist suggests that anger and d depression are primarily chemically based the therapist focuses on the patient's e problematic beliefs.…”

Section: Role Of Medication In Psychodynamic Treatment Of Anger and Dmentioning

confidence: 99%

Anger and depression

Busch¹

2009

Adv. psychiatr. treat

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SummaryA series of psychoanalytic theorists and clinicians have suggested that conflicts about anger play a central role in the development of depression. Research data have supported the notion that patients struggle with the experience and expression of angry feelings. Anger in people with depression often stems from narcissistic vulnerability, a sensitivity to perceived or actual loss or rejection. These angry reactions cause intrapsychic conflicts through the onset of guilt and the fear that angry feelings will disrupt relationships. These conflicts lead to anger being directed inwards, further lowering self-esteem, creating a vicious cycle. Defence mechanisms that are triggered, including passive aggression, reaction formation, denial and identification with the aggressor, are ineffective at managing these conflicts and further prevent the appropriate expression of anger. This article discusses how to identify and detoxify angry feelings and fantasies using a psychodynamic approach.

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Section: Role Of Medication In Psychodynamic Treatment Of Anger and Dmentioning

confidence: 99%

Anger and depression

Busch¹

2009

Adv. psychiatr. treat

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“…There is evidence supporting the effectiveness of LTDP and psychoanalysis (de Maat et al 2009), especially in long-term follow-ups (Knekt et al 2008(Knekt et al , 2011Huber et al 2013). There is also some indirect evidence that LTDP is superior to other psychotherapies in treating complex patients with chronic depression and previous treatment failures (Leichsenring & Rabung, 2008, 2010Fonagy et al in press).…”

Section: Long-term Dynamic Psychotherapy (Ltdp)mentioning

confidence: 99%

What we know, what we do not know, and where are we heading? Efficacy and acceptability of psychological interventions for depression

Solomonov

Barber

2015

Epidemiol Psychiatr Sci

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In the past several decades, increasing evidence supports the efficacy of psychotherapies for depression. The vast majority of findings from meta-analyses, randomized clinical trials (RCTs) and naturalistic studies have demonstrated that well-established psychotherapies (behavioural activation, problem-solving therapy, psychodynamic therapy, cognitive-behavioural therapy, interpersonal therapy and emotion-focused therapy) are superior to no-treatment and control conditions, and are in most cases equally effective in treating depression. However, despite this abundant support for psychotherapies, studies have also consistently shown high drop-out rates, high percentages of non-respondent patients who experience treatment failures, and mixed findings regarding the enduring effects of psychotherapy. Thus, there is a need to develop more personalised treatment models tailored to patients' needs. A new integrative sequential stepwise approach to the treatment of depression is suggested. Key words: Behaviour therapy, cognitive therapy, depression, evidence-based psychiatry, psychoanalysis and psychodynamic therapies. What do we know about the efficacy of psychotherapies for depression?Depression is a pervasive mental condition which interferes with all domains of one's functioning and it is one of the most common problems leading people to seek treatment (e.g. Summers & Barber, 2010). Recent studies have shown that the approximated cumulative incidence of depression diagnosis from childhood to adulthood is between 32.54 and 51% (Rohde et al. 2012;Angst et al. 2015).In the past several decades, over 400 randomised clinical trials have investigated the efficacy of psychotherapy for depression (Cuijpers, 2015). Despite the heated debate regarding the superiority of one treatment over others, there is fairly wide acceptance of the 'Dodo Bird Verdict ' (Luborsky et al. 1975), at least in the case of depression, suggesting that all treatments are more or less equally effective (Cuijpers et al. 2008;Barth et al. 2013). Furthermore, research in the past two decades has taught us that psychotherapeutic treatments of depression are superior to waitlist and other control conditions (Barth et al. 2013;Lambert, 2013), and that psychotherapy combined with anti-depressant medication is more effective than medication alone (Barber et al. 2013;Köhler et al. 2013;Hollon et al. 2014;Fonagy, 2015;Leichsenring et al. 2015). There is also evidence suggesting that some types of psychotherapies are not only as effective as medication, but also have higher long-term enduring effects (Hollon & Ponniah, 2010;Cuijpers et al. 2013b). We begin by briefly reviewing some of the major findings that have arisen from the literature on treatments of depression, focusing only on the best-known and more widely researched. Behavioural activation (BA)BA is one of the most accepted and widely used behavioural treatments. Meta analyses found BA to be as effective as cognitive-behavioural therapy, and superior to control conditions (Cuijpers et al. 2007;Mazzuc...

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“…Of the studies identified, four were conducted in The Netherlands [20][21][22][23][24], four in the USA [25][26][27][28][29] and one each in Canada, Finland, Denmark, and Japan [30][31][32][33][34]. Ten were randomised controlled trials (RCTs) [20][21][22][23][24][25][26][27][28][29][31][32][33] and two were non-randomised studies (NRSs) with a separate control group [30,34].…”

Section: Study Characteristics (See Appendix 5-electronic Supplementamentioning

confidence: 99%

“…Ten were randomised controlled trials (RCTs) [20][21][22][23][24][25][26][27][28][29][31][32][33] and two were non-randomised studies (NRSs) with a separate control group [30,34]. Studies were conducted in a variety of settings, including workplaces [20,29,30,34], primary care practices [25][26][27][28], occupational health services [21,22,24], and specialty medical clinics [23,[31][32][33].…”

Section: Study Characteristics (See Appendix 5-electronic Supplementamentioning

confidence: 99%

Systematic Review of Intervention Practices for Depression in the Workplace

et al. 2011

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Design Systematic Review. Objective To determine which intervention approaches to manage depression in the workplace have been successful and yielded value for employers in developed economies. Data Sources We searched MEDLINE, EMBASE, CINAHL, Central, PsycINFO, and Business Source Premier up to June 2010 using search terms in four broad areas: work setting, depression, intervention, and work outcomes. Study Selection Two independent reviewers selected potential articles that met the following criteria: working age individuals with mild or moderate depression; interventions or programs that were workplace-based or could be implemented and/or facilitated by the employer; inclusion of a comparator group in the analysis; outcomes of prevention, management, and recurrences of work disability or sickness absence, and work functioning. Methods Two reviewers independently reviewed each article for quality and extracted data using standardised forms. Following guidelines from the GRADE Working Group, the quality of evidence addressing each outcome was graded as high, moderate, low, or very low on the basis of six criteria: study design, risk of bias, consistency, generalisability, data precision, and economic benefit. Using this information and following Cochrane Collaboration guidelines, the findings for each intervention were summarised and key messages were developed. Results We identified ten randomised trials and two non-randomised studies from various countries and jurisdictions that evaluated a wide range of intervention practices. The evidence was graded as Access to Data Andrea Furlan had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.Electronic supplementary material The online version of this article

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Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up

Cited by 226 publications

References 42 publications

Anger and depression

Anger and depression

What we know, what we do not know, and where are we heading? Efficacy and acceptability of psychological interventions for depression

Systematic Review of Intervention Practices for Depression in the Workplace

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