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.

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

De Pascalis, Leonardo;
2023

Abstract

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.
2023
Wienicke, Frederik J.; Beutel, Manfred E.; Zwerenz, Rüdiger; Brähler, Elmar; Fonagy, Peter; Luyten, Patrick; Constantinou, Matthew; Barber, Jacques P.; McCarthy, Kevin S.; Solomonov, Nili; Cooper, Peter J.; De Pascalis, Leonardo; Johansson, Robert; Anderssonn, Gerhard; Lemma, Alessandra; Town, Joel M.; Abbass, Allan A.; Ajilchi, Bita; Connolly Gibbons, Mary Beth; López-Rodríguez, Jaime; Villamil-Salcedo, Valerio; Maina, Giuseppe; Rosso, Gianluca; Twisk, Jos W. R.; Burk, William J.; Spijker, Jan; Cuijpers, Pim; Driessen, Ellen
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/920378
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