Comparative effects of short-term psychodynamic psychotherapy and cognitive-behavioral therapy in depression: A meta-analytic approach

This article reviews the efficacy of short-term psychodynamic psychotherapy (STPP) in depression compared to cognitive-behavioral therapy (CBT) or beh avioral therapy (BT). In this review, only studies in which at least 13 the rapy sessions were performed have been included, and a sufficient number of patients per group were treated (N greater than or equal to 20). With rega rd to outcome criteria the results were reviewed for improvements in depres sive symptoms, general psychiatric symptoms, and social functioning. Six st udies met the inclusion criteria. Results: In 58 of the 60 comparisons (97 %) performed in the six studies and their follow-ups, no significant differ ence could be detected between STPP and CBT/BT concerning the effects in de pressive symptoms, general psychiatric symptomatology, and social functioni ng: Furthermore, STPP and CBT/BT did not differ significantly with regard t o the patients that were judged as remitted or improved. According to a met a-analytic procedure described by R. Rosenthal (1991) the studies do not di ffer significantly with regard to the patients that were judged as remitted or improved after treatment with STPP or CBT/BT. The mean difference betwe en STPP and CBT/BT concerning the number of patients that were judged as re mitted or improved corresponds to a small effect size (post-assessment: phi = 0.08, follow-up assessment: phi = 0. 12). Thus, STPP and CBT/BT seem to be equally effective methods in the treatment of depression. However, becau se of the small number of studies which met the inclusion criteria this res ult can only be preliminary. Furthermore, it applies only to the specific f orms of STPP that were examined in the selected studies and cannot be gener alized to other forms of STPP. Further studies are needed to examine the ef fects of specific forms of STPP in both controlled and naturalistic setting s. Furthermore, there are findings indicating that 16-20 sessions of both S TPP and CBT/BT are insufficient for most patients to achieve lasting remiss ion. Future studies should address the effects of longer treatments of depr ession. (C) 2001 Elsevier Science Ltd.