Open Door Review
@B*$7#!/647#)(#0%214!Q(B&4![@/Q^!h!=!(#%00E402%!:)<<)ZEB1!6(B&4?! 8)912%$6)*!):!7)D*$($Y0E30#2Y$)%2_!p$990%92**_!i>_!H0*%$7#_!S>_!G!I![+,-+^>!8)912%$6)*!):!7)D*$($Y0E30#2Y$)B%!(#0%214!Z$(#! 1647#)2*2<4($7!2*&!1647#)&4*29$7!(#0%214!:)%!&01%0660&!12($0*(6!h!=!(#%00E402%!:)<<)ZEB1!6(B&4>! i%),(?-#)!,& !j#&'(A?-"("$@,)(?-%&Z%*)f)+&>+*&'(A?-",-%#@:)% _!.b?!+\\hP-g>! HB30%_!O>_!H0*%$7#_!S>_!S26(*0%_!i>_!G!I![+,-+^>!"#0!@B*$7#!/647#)(#0%214!Q(B&4?!@B6(!2<!A0Y4_!Q>!=3<)*!G!H>!IJ7#0<0!['&6>^_! '(A?-"*A+@$)?&'(A?-",-%#@:A&3%(%@#?-C&2<)*%+?%V`@(%*&'#@?,)?%&@+*& '#@?,)?%V`@(%*&2<)*%+?% ![11>!.-Eg\^>!a0Z!e)%M?!HB92*2!/%066 >! W(*&,!>-001(3! In an extension of the above mentioned study we additionally investigated the effectiveness of long- term cognitive-behavioral therapy compared to psychoanalytic and psychodynamic therapy in the treatment of patients with depression. Therefore, in a quasi-experimental design 100 patients were compared at pre- and post-treatment and at three-year follow-up. Outcome measures see above. We found significant outcome differences between psychoanalytic therapy and cognitive-behavioral therapy in depressive and global psychiatric symptoms, social-interpersonal and personality structure at three-year follow-up. Psychodynamic therapy was superior to cognitive-behavioral therapy only in the reduction of interpersonal problems. We conclude that psychoanalytic (and partly psychodynamic) therapy shows significantly higher and longer-lasting effects compared to cognitive-behavioral therapy three years after termination of treatment. @)15-1.*$#! This study moves in the middle of the pragmatic-explanatory continuum, having significant scientific strengths as well as the potential capacity to inform healthcare decision-making regarding clinical practice; thus it can be rubricated as a pragmatic or practical clinical trial. Our study has several limitations as well, as the small sample sizes and the lack of a Structured Clinical Interview for DSM-IV (SCID-I and SCID-II) assessment of primary and co-morbid diagnoses. In terms of internal validity, the differing dose of the treatments (i.e., the number of sessions) can be considered to be a confounder. We believe that each treatment has a different underlying working model that needs a specified time frame with a stipulated number of sessions and specific interventions in order to initiate a specific process. Moreover, we deliberately wanted to investigate treatment packages with their prototypical doses to inform practitioners about their everyday practice, thus helping to bridge the notorious gap between research and practice. This study should enlarge our empirically based knowledge of the enduring effects of long-term psychotherapies, especially psychoanalytic therapy. G$#.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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