Open Door Review

@B*$7#!/647#)(#0%214!Q(B&4![@/Q^!h!=!(#%00E402%!:)<<)ZEB1!6(B&4?! /647#)2*2<4($7!Y6>!1647#)&4*29$7!(#0%214!:)%!&01%066$)*!

HB30%_!O>_!H0*%$7#_!S>_!8<2%M$*_!i>!G!I![+,-P^>!/647#)2*2<4($7!Y0%6B6!1647#)&4*29$7!(#0%214!:)%! &01%066$)*?!2!(#%00E402%!:)<<)ZEB1!6(B&4>! '(A?-)@,#A _! bg _!+_!-P+E-]\>! W(*&,!>-001(3! The aim of this study was to investigate the effectiveness of long-term psychotherapies. In a prospective, randomized outcome study, psychoanalytic therapy (mean duration: 39 months, mean dose: 234 sessions) and psychodynamic therapy (mean duration: 34 months, mean dose: 88 sessions) were compared at post-treatment and at one-, two-, and three-year follow-up in the treatment of patients with a primary diagnosis of unipolar depression. All treatments were performed by experienced psychotherapists / psychoanalysts. Independent raters assessed treatment fidelity using the Psychotherapy Process Q-set. A two-tailed t-test yielded a significant difference in therapeutic technique between the therapy-groups. Primary outcome measures were the Beck Depression Inventory and the Scales of Psychological Capacities, and secondary outcome measures were Global Severity Index of the SCL-90-R, the Inventory of Interpersonal Problems, the Social Support Questionnaire, and the INTREX Introject Questionnaire. Interviewers at pre- and post-treatment and at one-year follow-up were blinded; at two-, and three-year follow-up all self-report instruments were mailed to the patients. Analyses of covariance, effect sizes and clinical significances were calculated to contrast the groups. We found significant outcome differences between treatments in terms of depressive and global psychiatric symptoms, personality functioning and social relations at three-year follow-up with psychoanalytic therapy being significantly more effective. No outcome differences were found in terms of interpersonal problems. We concluded that psychoanalytic therapy with its higher dose and frequency and different therapeutic technique shows longer-lasting effects than psychodynamic therapy, demonstrating the full range of its benefits three years after termination of treatment. G$#.1/.\! Professor Dorothea Huber, M.D., Ph.D. International Psychoanalytic University (IPU), Stromstrasse 3, 10555 Berlin, Germany. Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum München, Sanatoriumsplatz 2, 81545 München.

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