Comparative effectiveness of short-term psychodynamic psychotherapy and cognitive behavioral therapy for major depression in psychiatric outpatient clinics: a randomized controlled trial.

IF 3.4 2区医学 Q2 PSYCHIATRY

BMC Psychiatry Pub Date : 2025-02-11 DOI:10.1186/s12888-025-06544-6

Anders Malkomsen, Theresa Wilberg, Bente Bull-Hansen, Toril Dammen, Julie Horgen Evensen, Benjamin Hummelen, André Løvgren, Kåre Osnes, Randi Ulberg, Jan Ivar Røssberg

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引用次数: 0

Abstract

Background: More studies with low risk of bias on the effectiveness of cognitive behavioral therapy (CBT) and short-term psychodynamic psychotherapy (STPP) for major depressive disorder (MDD) are needed. This study compares the outcome of CBT and STPP and examines the improvements in each treatment, focusing on effect sizes, reliable change, dropout rates, and remission rates, using broad inclusion criteria (e.g. participants using antidepressants or with strong suicidal ideation).

Methods: One hundred patients were randomly allocated to CBT or STPP. All patients were offered either 16 weekly sessions followed by 3 monthly booster sessions in CBT, or 28 weekly sessions in STPP. Primary outcome measures were Hamilton Depression Rating Scale (HDRS) and Beck's Depression Inventory-II (BDI-II). Secondary outcome measures were Work and Social Adjustment Scale (WSAS), Generalized Anxiety Disorder-7 (GAD-7), Global Assessment of Functioning (GAF) and Short Form Health Survey-12 (SF-12).

Results: No significant differences in outcomes were found between the two treatment groups on any of the measures. The within-group effects were large (> 0.8) for the primary outcome measures and moderate to large for the secondary outcome measures. According to the reliable change index (RCI), 79% of patients reliably improved on HDRS and 76% improved on BDI-II, whereas respectively 6% and 10% reliably deteriorated.

Conclusions: These findings support the assumption that CBT and STPP are equally effective treatments for patients with depressive disorders in psychiatric outpatient clinics. Additionally, they strengthen the evidence for the effectiveness of both CBT and STPP in these settings, while also highlighting that not all depressed patients respond to short-term treatment.

Clinical trial registration: Clinical Trial gov. Identifier: NCT03022071. Date of registration: 2016-11-14.

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来源期刊

BMC Psychiatry 医学-精神病学

CiteScore

5.90

自引率

4.50%

发文量

716

审稿时长

3-6 weeks

期刊介绍： BMC Psychiatry is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of psychiatric disorders, as well as related molecular genetics, pathophysiology, and epidemiology.