Efficacy and moderators of short-term psychodynamic psychotherapy for depression: A systematic review and meta-analysis of individual participant data.

Background: Short-term psychodynamic psychotherapy (STPP) is frequently used to treat depression, but it is unclear which patients might benefit specifically. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses and identify patient-level moderators. This IPD meta-analysis examined the efficacy and moderators of STPP for depression compared to control conditions.
Methods: PubMed, PsycInfo, Embase, and Cochrane Library were searched September 1st, 2022, to identify randomized trials comparing STPP to control conditions for adults with depression. IPD were requested and analyzed using mixed-effects models.
Results: IPD were obtained from 11 of the 13 (84.6%) studies identified (n = 771/837, 92.1%; mean age = 40.8, SD = 13.3; 79.3% female). STPP resulted in significantly lower depressive symptom levels than control conditions at post-treatment (d = -0.62, 95%CI [-0.76, -0.47], p < .001). At post-treatment, STPP was more efficacious for participants with longer rather than shorter current depressive episode durations.
Conclusions: These results support the evidence base of STPP for depression and indicate episode duration as an effect modifier. This moderator finding, however, is observational and requires prospective validation in future large-scale trials.
Competing Interests: Declaration of Competing Interest Ellen Driessen has received grants from the American Psychoanalytic Association, the Dutch Psychoanalytic Funds, and the Netherlands Organization of Scientific Research (NWO; 016.Veni.195.2156806) to support the research described in this article. Patrick Luyten has been involved in the development, evaluation, and dissemination of psychodynamic treatments. Frederik Wienicke, Manfred Beutel, Rüdiger Zwerenz, Elmar Brähler, Peter Fonagy, Matthew Constantinou, Jacques Barber, Kevin McCarthy, Nili Solomonov, Peter Cooper, Leonardo De Pascalis, Robert Johansson, Gerhard Andersson, Alessandra Lemma, Joel Town, Allan Abbass, Bita Ajilchi, Mary Beth Connolly Gibbons, Jaime López-Rodríguez, Valerio Villamil-Salcedo, Giuseppe Maina, Gianluca Rosso, Jos Twisk, William Burk, Jan Spijker, and Pim Cuijpers declare no conflict of interest.
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