?(&1.0&#.! Psychoanalytic treatment consisted of twice weekly therapy sessions of 50 minutes with the child and bi-weekly sessions of 50 minutes with parents provided by psychoanalysts in private practice. The treatment length varied from child to child. In average, the psychoanalytic treatment lasted 25.9 months (SD = 9.62). The manual by A. Staufenberg was developed during the Frankfurt Prevention Study between and was accepted and implemented by all psychoanalysts participating in the study. Behavioral/medication treatment. Children attended either a manualized six-week concentration- training program or they attended a manualized two week anti-aggression training program. A parent- training program accompanied both programs. Additionally, children were prescribed methylphenidate, if needed, by a psychiatrist. In total, 63.3% of the children were medicated for a time period of 29.6 months on average (SD = 15.89). ;&2-5.2! Fifty-four children (74.0%) completed the follow-up 38 months on average after the baseline. Both treatment groups demonstrated significant symptom reduction, with no significant differences in effectiveness between the two groups. Teacher ratings as well as parent ratings showed a significant decline over time on the ADHD index scores, on oppositional behavior and hyperactivity/impulsivity levels and on internalizing and externalizing problem scores. Both groups demonstrated similar main effects of time. There were no significant interactions between group and time. The findings support the hypothesis that psychoanalytic psychotherapy without medication is as effective as behavioral therapy and/or medication treatment. @)15-1.*$#! While it is the first study of its kind, the study has limitations. First, the sample size is relatively small. Second, pertaining to the naturalistic design, one weakness is the resulting heterogeneity, which is evident both within and between the groups. This heterogeneity led to a biased sample in certain areas. The strength of the study is the naturalistic design. Psychotherapies were investigated as they were realized in the offices and institutions of ‘real’ psychotherapists with ‘real’ patients in Frankfurt nowadays associated with a high external validity of the findings. The study has scientifically followed severely disadvantaged children with a diagnosis of ADHD and/or ODD and their families over the course of a long-term psychoanalytical therapy and compared them in a naturalistic setting to a comparative group providing already well-validated behavioral/medication treatment. In this respect, the study is pioneer work. G5*#*/15!?(*15!;&Y*2.(1.*$#!
DRKS-ID: DRKS00003356 http://apps.who.int/trialsearch/trial.aspx?trialid=DRKS00003356
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Katrin Luise Laezer laezer@sigmund-freud-institut.de Marianne Leuzinger-Bohleber m.leuzinger-bohleber@sigmund-freud-institut.de
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