Efficacy and Moderators of Short-Term Psychodynamic Psychotherapy for Depression: A Systematic Review and Meta-Analysis of Individual Participant Data

Background: Short-term psychodynamic psychotherapy (STPP) is frequently used to treat depression, but it is unclear which patients might benefit specifically. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional metaanalyses and identify patient-level moderators. This IPD meta-analysis examined the efficacy and moderators of STPP for depression compared to control conditions. Methods: PubMed, PsycInfo, Embase, and Cochrane Library were searched January 1st, 2022, to identify randomized trials comparing STPP to control conditions for adults with depression. IPD were requested and analyzed using mixed-effects models. Results: IPD were obtained from 11 of the 13 (84.6%) studies identified (n = 771/837, 92.1%). STPP resulted in significantly lower levels of depressive symptom than control conditions at post-treatment (d = -0.62) and follow-up (d = -0.21). STPP was more efficacious for participants with high rather than low baseline depression levels at both post-treatment and follow-up. Age of depression onset was significantly associated with STPP efficacy at posttreatment, such that participants with younger ages of onset benefitted most. Conclusions: These results support the evidence-base of STPP for depression and indicate baseline severity and age of onset as effect modifiers. Future large-scale trials are needed to prospectively test these moderators.