Level of Evidence = B


Short-term psychodynamic psychotherapies (STPP) appear to be effective for general, somatic, anxiety, and depressive symptom reduction, as well as social adjustment. The effect is generally maintained in long term follow-up.

A Cochrane review [1] included 23 studies with a total of 1431 subjects. In the STPP group, significant improvements in general psychiatric symptoms were found relative to controls in the short-term (SMD -0.42, 95% CI -0.58 to -0.27, 13 studies, n=816) and long-term (SMD -0.51, 95% CI -0.72 to -0.31, 5 studies, n=445). Somatic measures also showed significant treatment effects relative to controls in the short-term (SMD -0.67, 95% CI -0.85 to -0.48, 7 studies, n=537) and long-term (SMD -0.95, 95% CI -1.19 to -0.70, 4 studies, n=381). Anxiety ratings showed moderate treatment effects relative to controls in the short-term SMD -0.46, 95% CI -0.64 to -0.27, (11 studies, n=601), and long-term (SMD -0.46, 95% CI -0.71 to -0.21, 5 studies, n=333). Measures of depression showed moderate treatment effects relative to controls in the short-term (SMD -0.47, 95% CI -0.61 to -0.33, 11 studies, n=927) and long-term (SMD -0.78, 95% CI -0.99 to -0.57, 6 studies, n=422). Reports on social adjustment showed significant and modest effects in the short term (SMD -0.51, 95% CI -0.76 to -0.26, 3 studies, n=254) and long-term SMD -0.45, 95% CI -0.70 to -0.21, (3 studies, n=260). Comment: The quality of evidence is downgraded by limitations in study quality (lack of specific diagnostic criteria in some studies, diversity of the treatment methods, questionable quality of psychotherapy provided). There was significant heterogeneity between studies, and results were not always maintained in sensitivity analyses. No data were available for patient satisfaction and health service use.