Psychodynamic therapy on par with CBT, pharmacotherapy in treating mental disorders
Psychodynamic therapy is comparable with other established treatments, including pharmacotherapy and cognitive-behavioural therapy (CBT), in terms of efficacy, a recent study has shown.
Researchers formally tested the equivalence of psychodynamic therapy to treatments established in efficacy and controlled for researcher allegiance effects by including representatives of psychodynamic therapy and CBT, the main rival psychotherapeutic treatments (adversarial collaboration).
The formal criteria for testing equivalence was applied, implying a particularly strict test: a priori definition of a margin compatible with equivalence (g=0.25), using the two one-sided test procedure and ensuring the efficacy of the comparator. Independent raters evaluated effect sizes, study quality, as well as allegiance.
The following criteria were used in the systematic literature search: randomized controlled trial of manual-guided psychodynamic therapy in adults, testing psychodynamic therapy against a treatment with efficacy established for the disorder under study, and applying reliable and valid outcome measures. “Target symptoms” (eg, depressive symptoms in depressive disorder) was the main outcome.
A total of 23 randomized controlled trials with 2,751 patients met the inclusion criteria. Reliable rating methods showed that the mean quality of studies was good.
Based on statistical analyses, psychodynamic therapy was equivalent to comparison conditions for target symptoms at post-treatment (g=‒0.153; 90 percent equivalence CI, ‒0.227 to ‒0.079) and at follow-up (g=‒0.049; ‒0.137 to ‒0.038) since both CIs were included in the equivalence interval (‒0.25 to 0.25).
“Further research should examine who benefits most from which treatment,” according to researchers, adding that pharmacotherapy, CBT and psychodynamic therapy were the most frequently applied strategies for treatment of mental disorders.