The long-term effectiveness of psychodynamic and analytical psychotherapy in routine care: Results from a naturalistic study over 6 years.

IF 6 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2025-12-01 DOI:10.1037/ccp0000985

Miriam Henkel,Johannes Zimmermann,Matthias Volz,Dorothea Huber,Hermann Staats,Cord Benecke

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Abstract

OBJECTIVE This naturalistic study examines the long-term effectiveness of two psychoanalytically oriented therapies-psychodynamic psychotherapy (PP) and analytical psychotherapy (AP)-in routine care settings in Germany. METHOD A total of 428 patients diagnosed with various mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, underwent treatment with either PP or AP. Diagnoses were reassessed at the end of treatment, and patients provided annual self-reports of their mental health over a 6-year period. We employed propensity score methods and piecewise linear latent growth curve models to estimate treatment effects on primary outcomes (i.e., number of diagnoses, symptom distress) and secondary outcomes (i.e., personality dysfunction, interpersonal problems, general life satisfaction). RESULTS Patients exhibited substantial and sustained improvements across all outcomes in both treatments. Notably, those receiving AP experienced greater (long-term) improvement in primary and most secondary outcomes compared to those in PP. Improvements in PP primarily occurred during the 1st year, while AP patients continued to show progress throughout the entire observation period. For some outcomes (symptom distress, personality dysfunction, and interpersonal problems), AP was particularly effective for patients with more severe problems at baseline. CONCLUSIONS Psychoanalytically oriented treatments in routine care are associated with substantial and lasting improvements, even posttreatment. Our findings highlight an incremental benefit of AP over PP, particularly for complex cases. Future research should explore treatment mechanisms, cost-effectiveness, and implications for health policy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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心理动力学和分析性心理治疗在常规护理中的长期有效性：来自一项超过6年的自然主义研究的结果。

目的：本自然主义研究考察了德国常规护理环境中两种以精神分析为导向的治疗方法——精神动力心理治疗（PP）和分析性心理治疗（AP）的长期有效性。方法：共有428名根据《精神疾病诊断与统计手册》（第四版）诊断为各种精神障碍的患者接受了PP或AP治疗。在治疗结束时对诊断进行重新评估，患者每年提供6年期间的精神健康自我报告。我们采用倾向评分方法和分段线性潜在增长曲线模型来估计治疗对主要结局（即诊断次数、症状困扰）和次要结局（即人格功能障碍、人际关系问题、总体生活满意度）的影响。结果在两种治疗中，患者在所有结果中均表现出显著和持续的改善。值得注意的是，与接受PP治疗的患者相比，接受AP治疗的患者在主要和大多数次要预后方面有更大的（长期）改善。PP的改善主要发生在第一年，而AP患者在整个观察期内持续表现出进展。对于某些结果（症状困扰、人格功能障碍和人际关系问题），AP对基线时问题更严重的患者特别有效。结论在常规护理中，以心理分析为导向的治疗与实质性和持久的改善相关，甚至在治疗后也是如此。我们的研究结果强调了AP优于PP的益处，特别是对于复杂的病例。未来的研究应探讨治疗机制、成本效益和对卫生政策的影响。（PsycInfo Database Record (c) 2025 APA，版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.