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Falk Leichsenring - One of the best experts on this subject based on the ideXlab platform.
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on mechanisms of change in psychodynamic therapy
Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie, 2018Co-Authors: Falk Leichsenring, Christiane Steinert, Paul CritschristophAbstract:BACKGROUND There is a growing body of evidence for the efficacy of psychodynamic therapy. Some representatives of other approaches, however, have repeatedly questioned its efficacy. Recently, another line of argumentation emerged, claiming that psychodynamic therapy may work, but that the mechanisms of change underlying its effects were not clear or even could not be tested empirically at all. OBJECTIVE The present article critically reviews these allegations. RESULTS The allegations put forward were shown to be mostly untenable. Mechanisms of change of psychodynamic therapy are testable and have been tested empirically. CONCLUSIONS There is evidence for both the efficacy of psychodynamic therapy and for the assumed mechanisms of change. The repeatedly presented critique by representatives of other approaches seems to be motivated more by political than by scientific reasons. However, further research on both the outcome and process of psychodynamic therapy is required.
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psychodynamic therapy as efficacious as other empirically supported treatments a meta analysis testing equivalence of outcomes
American Journal of Psychiatry, 2017Co-Authors: Christiane Steinert, Thomas Munder, Sven Rabung, Jurgen Hoyer, Falk LeichsenringAbstract:Objective:Pharmacotherapy, cognitive-behavioral therapy (CBT), and psychodynamic therapy are most frequently applied to treat mental disorders. However, whether psychodynamic therapy is as efficacious as other empirically supported treatments is not yet clear. Thus, for the first time the equivalence of psychodynamic therapy to treatments established in efficacy was formally tested. The authors controlled for researcher allegiance effects by including representatives of psychodynamic therapy and CBT, the main rival psychotherapeutic treatments (adversarial collaboration).Method:The authors applied the formal criteria for testing equivalence, implying a particularly strict test: a priori defining a margin compatible with equivalence (g=0.25), using the two one-sided test procedure, and ensuring the efficacy of the comparator. Independent raters assessed effect sizes, study quality, and allegiance. A systematic literature search used the following criteria: randomized controlled trial of manual-guided psych...
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psychodynamic therapy and cognitive behavioral therapy in social anxiety disorder a multicenter randomized controlled trial
American Journal of Psychiatry, 2013Co-Authors: Falk Leichsenring, Stephan Herpertz, Simone Salzer, Manfred E Beutel, Wolfgang Hiller, Juergen Hoyer, Johannes Huesing, Peter Joraschky, Bjoern Nolting, Karin PoehlmannAbstract:ObjectiveVarious approaches to cognitive-behavioral therapy (CBT) have been shown to be effective for social anxiety disorder. For psychodynamic therapy, evidence for efficacy in this disorder is scant. The authors tested the efficacy of psychodynamic therapy and CBT in social anxiety disorder in a multicenter randomized controlled trial.MethodIn an outpatient setting, 495 patients with social anxiety disorder were randomly assigned to manual-guided CBT (N=209), manual-guided psychodynamic therapy (N=207), or a waiting list condition (N=79). Assessments were made at baseline and at end of treatment. Primary outcome measures were rates of remission and response, based on the Liebowitz Social Anxiety Scale applied by raters blind to group assignment. Several secondary measures were assessed as well.ResultsRemission rates in the CBT, psychodynamic therapy, and waiting list groups were 36%, 26%, and 9%, respectively. Response rates were 60%, 52%, and 15%, respectively. CBT and psychodynamic therapy were signi...
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short term psychodynamic psychotherapy and cognitive behavioral therapy in generalized anxiety disorder a randomized controlled trial
FOCUS, 2010Co-Authors: Falk Leichsenring, Simone Salzer, Ulrich Jaeger, Horst Kachele, Reinhard Kreische, Frank Leweke, Ulrich Ruger, Christel Winkelbach, Eric LeibingAbstract:Objective:While several studies have shown that cognitive-behavioral therapy (CBT) is an efficacious treatment for generalized anxiety disorder, few studies have addressed the outcome of short-term psychodynamic psychotherapy, even though this treatment is widely used. The aim of this study was to compare short-term psychodynamic psychotherapy and CBT with regard to treatment outcome in generalized anxiety disorder. Method:Patients with generalized anxiety disorder according to DSM-IV were randomly assigned to receive either CBT (N=29) or short-term psychodynamic psychotherapy (N=28). Treatments were carried out according to treatment manuals and included up to 30 weekly sessions. The primary outcome measure was the Hamilton Anxiety Rating Scale, which was applied by trained raters blind to the treatment conditions. Assessments were carried out at the completion of treatment and 6 months afterward. Results:Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improveme...
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short term psychodynamic psychotherapy and cognitive behavioral therapy in generalized anxiety disorder a randomized controlled trial
FOCUS, 2010Co-Authors: Falk Leichsenring, Simone Salzer, Ulrich Jaeger, Horst Kachele, Reinhard Kreische, Frank Leweke, Ulrich Ruger, Christel Winkelbach, Eric LeibingAbstract:Objective: While several studies have shown that cognitive-behavioral therapy (CBT) is an efficacious treatment for generalized anxiety disorder, few studies have addressed the outcome of shortterm psychodynamic psychotherapy, even though this treatment is widely used. The aim of this study was to compare short-term psychodynamic psychotherapy and CBT with regard to treatment outcome in generalized anxiety disorder. Method: Patients with generalized anxiety disorder according to DSM-IV were randomly assigned to receive either CBT (N=29) or short-term psychodynamic psychotherapy (N=28). Treatments were carried out according to treatment manuals and included up to 30 weekly sessions. The primary outcome measure was the Hamilton Anxiety Rating Scale, which was applied by trained raters blind to the treatment conditions. Assessments were carried out at the completion of treatment and 6 months afterward. Results: Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improvements with regard to symptoms of anxiety and depression. No significant differences in outcome were found between treatments in regard to the primary outcome measure. These results were corroborated by two self-report measures of anxiety. In measures of trait anxiety, worry, and depression, however, CBT was found to be superior. Conclusions: The results suggest that CBT and short-term psychodynamic psychotherapy are beneficial for patients with generalized anxiety disorder. In future research, large-scale multicenter studies should examine more subtle differences between treatments, including differences in the patients who benefit most from each form of therapy.
Eric Leibing - One of the best experts on this subject based on the ideXlab platform.
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short term psychodynamic psychotherapy and cognitive behavioral therapy in generalized anxiety disorder a randomized controlled trial
FOCUS, 2010Co-Authors: Falk Leichsenring, Simone Salzer, Ulrich Jaeger, Horst Kachele, Reinhard Kreische, Frank Leweke, Ulrich Ruger, Christel Winkelbach, Eric LeibingAbstract:Objective:While several studies have shown that cognitive-behavioral therapy (CBT) is an efficacious treatment for generalized anxiety disorder, few studies have addressed the outcome of short-term psychodynamic psychotherapy, even though this treatment is widely used. The aim of this study was to compare short-term psychodynamic psychotherapy and CBT with regard to treatment outcome in generalized anxiety disorder. Method:Patients with generalized anxiety disorder according to DSM-IV were randomly assigned to receive either CBT (N=29) or short-term psychodynamic psychotherapy (N=28). Treatments were carried out according to treatment manuals and included up to 30 weekly sessions. The primary outcome measure was the Hamilton Anxiety Rating Scale, which was applied by trained raters blind to the treatment conditions. Assessments were carried out at the completion of treatment and 6 months afterward. Results:Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improveme...
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short term psychodynamic psychotherapy and cognitive behavioral therapy in generalized anxiety disorder a randomized controlled trial
FOCUS, 2010Co-Authors: Falk Leichsenring, Simone Salzer, Ulrich Jaeger, Horst Kachele, Reinhard Kreische, Frank Leweke, Ulrich Ruger, Christel Winkelbach, Eric LeibingAbstract:Objective: While several studies have shown that cognitive-behavioral therapy (CBT) is an efficacious treatment for generalized anxiety disorder, few studies have addressed the outcome of shortterm psychodynamic psychotherapy, even though this treatment is widely used. The aim of this study was to compare short-term psychodynamic psychotherapy and CBT with regard to treatment outcome in generalized anxiety disorder. Method: Patients with generalized anxiety disorder according to DSM-IV were randomly assigned to receive either CBT (N=29) or short-term psychodynamic psychotherapy (N=28). Treatments were carried out according to treatment manuals and included up to 30 weekly sessions. The primary outcome measure was the Hamilton Anxiety Rating Scale, which was applied by trained raters blind to the treatment conditions. Assessments were carried out at the completion of treatment and 6 months afterward. Results: Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improvements with regard to symptoms of anxiety and depression. No significant differences in outcome were found between treatments in regard to the primary outcome measure. These results were corroborated by two self-report measures of anxiety. In measures of trait anxiety, worry, and depression, however, CBT was found to be superior. Conclusions: The results suggest that CBT and short-term psychodynamic psychotherapy are beneficial for patients with generalized anxiety disorder. In future research, large-scale multicenter studies should examine more subtle differences between treatments, including differences in the patients who benefit most from each form of therapy.
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short term psychodynamic psychotherapy and cognitive behavioral therapy in generalized anxiety disorder a randomized controlled trial
American Journal of Psychiatry, 2009Co-Authors: Falk Leichsenring, Simone Salzer, Ulrich Jaeger, Horst Kachele, Reinhard Kreische, Frank Leweke, Ulrich Ruger, Christel Winkelbach, Eric LeibingAbstract:Objective: While several studies have shown that cognitive-behavioral therapy (CBT) is an efficacious treatment for generalized anxiety disorder, few studies have addressed the outcome of short-term psychodynamic psychotherapy, even though this treatment is widely used. The aim of this study was to compare short-term psychodynamic psychotherapy and CBT with regard to treatment outcome in generalized anxiety disorder. Method: Patients with generalized anxiety disorder according to DSM-IV were randomly assigned to receive either CBT (N=29) or short-term psychodynamic psychotherapy (N=28). Treatments were carried out according to treatment manuals and included up to 30 weekly sessions. The primary outcome measure was the Hamilton Anxiety Rating Scale, which was applied by trained raters blind to the treatment conditions. Assessments were carried out at the completion of treatment and 6 months afterward. Results: Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improv...
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the effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders a meta analysis
FOCUS, 2005Co-Authors: Falk Leichsenring, Eric LeibingAbstract:Objective: The authors conducted a meta-analysis to address the effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders. Method: Studies of psychodynamic therapy and cognitive behavior therapy that were published between 1974 and 2001 were collected. Only studies that 1) used standardized methods to diagnose personality disorders, 2) applied reliable and valid instruments for the assessment of outcome, and 3) reported data that allowed calculation of within-group effect sizes or assessment of personality disorder recovery rates were included. Fourteen studies of psychodynamic therapy and 11 studies of cognitive behavior therapy were included. Results: Psychodynamic therapy yielded a large overall effect size (1.46), with effect sizes of 1.08 found for self-report measures and 1.79 for observer-rated measures. For cognitive behavior therapy, the corresponding values were 1.00, 1.20, and 0.87. For more specific measures of personality disorder patholog...
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the effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders a meta analysis
American Journal of Psychiatry, 2003Co-Authors: Falk Leichsenring, Eric LeibingAbstract:OBJECTIVE: The authors conducted a meta-analysis to address the effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders. METHOD: Studies of psychodynamic therapy and cognitive behavior therapy that were published between 1974 and 2001 were collected. Only studies that 1) used standardized methods to diagnose personality disorders, 2) applied reliable and valid instruments for the assessment of outcome, and 3) reported data that allowed calculation of within-group effect sizes or assessment of personality disorder recovery rates were included. Fourteen studies of psychodynamic therapy and 11 studies of cognitive behavior therapy were included. RESULTS: Psychodynamic therapy yielded a large overall effect size (1.46), with effect sizes of 1.08 found for self-report measures and 1.79 for observer-rated measures. For cognitive behavior therapy, the corresponding values were 1.00, 1.20, and 0.87. For more specific measures of personality disorder patholog...
Christian Gluud - One of the best experts on this subject based on the ideXlab platform.
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the effect of adding psychodynamic therapy to antidepressants in patients with major depressive disorder a systematic review of randomized clinical trials with meta analyses and trial sequential analyses
Journal of Affective Disorders, 2012Co-Authors: Janus Christian Jakobsen, Jane Lindschou Hansen, Erik Simonsen, Christian GluudAbstract:Abstract Background Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Psychodynamic therapy may be a treatment option for depression, but the effects have only been limitedly assessed in systematic reviews. Method Using Cochrane systematic review methodology, we compared the benefits and harms of psychodynamic therapy versus ‘no intervention’ or sham for major depressive disorder. We accepted any co-intervention, including antidepressants, as long as it was delivered similarly in both intervention groups. Trials were identified by searching the Cochrane Library's CENTRAL, MEDLINE via PubMed, EMBASE, Psychlit, Psyc Info, and Science Citation Index Expanded until February 2010. Two authors independently extracted data. We evaluated risk of bias to control for systematic errors. We conducted trial sequential analysis to control for random errors. Results We included five trials randomizing a total of 365 participants who all received antidepressants as co-intervention. All trials had high risk of bias. Four trials assessed ‘interpersonal psychotherapy’ and one trial ‘short psychodynamic supportive psychotherapy’. Meta-analysis showed that psychodynamic therapy significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference − 3.01 (95% confidence interval − 3.98 to − 2.03; P Limitations Our results are based on few trials with high risk of bias and a limited number of participants so our results may be questionable. Conclusions Adding psychodynamic therapy to antidepressants might benefit depressed patients, but the possible treatment effect measured on the Hamilton Rating Scale for Depression is small.
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the effect of interpersonal psychotherapy and other psychodynamic therapies versus treatment as usual in patients with major depressive disorder
PLOS ONE, 2011Co-Authors: Janus Christian Jakobsen, Jane Lindschou Hansen, Erik Simonsen, Christian GluudAbstract:Background: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment in systematic reviews. Methods/Principal Findings: Cochrane systematic review methodology with meta-analysis and trial sequential analysis of randomized trials comparing the effect of psychodynamic therapies versus ‘treatment as usual’ for major depressive disorder. To be included the participants had to be older than 17 years with a primary diagnosis of major depressive disorder. Altogether, we included six trials randomizing a total of 648 participants. Five trials assessed ‘interpersonal psychotherapy’ and only one trial assessed ‘psychodynamic psychotherapy’. All six trials had high risk of bias. Meta-analysis on all six trials showed that the psychodynamic interventions significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference 23.12 (95% confidence interval 24.39 to 21.86;P,0.00001), no heterogeneity) compared with ‘treatment as usual’. Trial sequential analysis confirmed this result. Discussion: We did not find convincing evidence supporting or refuting the effect of interpersonal psychotherapy or psychodynamic therapy compared with ‘treatment as usual’ for patients with major depressive disorder. The potential beneficial effect seems small and effects on major outcomes are unknown. Randomized trials with low risk of systematic errors and low risk of random errors are needed.
Ellen Driessen - One of the best experts on this subject based on the ideXlab platform.
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emerging evidence for intensive short term dynamic psychotherapy with personality disorders and somatic disorders
Psychiatric Annals, 2013Co-Authors: Joel M Town, Ellen DriessenAbstract:CME EducationaL Objectives 1. Review the outcome evidence of prior meta-analytic reviews of intensive short-term dynamic psychotherapy (ISTDP). 2. Provide an additional meta-analysis of ISTDP for the treatment of personality and somatic disorders. 3. Suggest areas for future study in the use of psychodynamic psychotherapy for personality and somatic disorders. The literature reviewing studies of psychodynamic psychotherapy clearly demonstrates evidence for the efficacy of both short-term and long-term models. Meta-analytic reviews synthesizing effects across different psychodynamic psychotherapy formats have been conducted for common mental disorders, depression, depression in the setting of personality disorder, personality disorders, and somatic disorders. Psychodynamic psychotherapy demonstrates superiority to control condition, and no significant difference to other formal psychotherapies, including cognitive behavioral therapies. Building upon a recently published systematic review and meta-analysis,11 the aim of this article is to further examine the evidence for a contemporary psychodynamic psychotherapy treatment protocol, intensive short-term dynamic psychotherapy (ISTDP), in the treatment of personality and somatic disorders.
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the efficacy of cognitive behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression a randomized clinical trial
American Journal of Psychiatry, 2013Co-Authors: Ellen Driessen, Jaap Peen, Jos W R Twisk, Pim Cuijpers, Simone Kool, Dieuwertje Westra, Marielle Hendriksen, Robert A Schoevers, Jack DekkerAbstract:ObjectiveThe efficacy of psychodynamic therapies for depression remains open to debate because of a paucity of high-quality studies. The authors compared the efficacy of psychodynamic therapy with that of cognitive-behavioral therapy (CBT), hypothesizing nonsignificant differences and the noninferiority of psychodynamic therapy relative to CBT.MethodA total of 341 adults who met DSM-IV criteria for a major depressive episode and had Hamilton Depression Rating Scale (HAM-D) scores ≥14 were randomly assigned to 16 sessions of individual manualized CBT or short-term psychodynamic supportive therapy. Severely depressed patients (HAM-D score >24) also received antidepressant medication according to protocol. The primary outcome measure was posttreatment remission rate (HAM-D score ≤7). Secondary outcome measures included mean posttreatment HAM-D score and patient-rated depression score and 1-year follow-up outcomes. Data were analyzed with generalized estimating equations and mixed-model analyses using intent-...
Janus Christian Jakobsen - One of the best experts on this subject based on the ideXlab platform.
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the effect of adding psychodynamic therapy to antidepressants in patients with major depressive disorder a systematic review of randomized clinical trials with meta analyses and trial sequential analyses
Journal of Affective Disorders, 2012Co-Authors: Janus Christian Jakobsen, Jane Lindschou Hansen, Erik Simonsen, Christian GluudAbstract:Abstract Background Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Psychodynamic therapy may be a treatment option for depression, but the effects have only been limitedly assessed in systematic reviews. Method Using Cochrane systematic review methodology, we compared the benefits and harms of psychodynamic therapy versus ‘no intervention’ or sham for major depressive disorder. We accepted any co-intervention, including antidepressants, as long as it was delivered similarly in both intervention groups. Trials were identified by searching the Cochrane Library's CENTRAL, MEDLINE via PubMed, EMBASE, Psychlit, Psyc Info, and Science Citation Index Expanded until February 2010. Two authors independently extracted data. We evaluated risk of bias to control for systematic errors. We conducted trial sequential analysis to control for random errors. Results We included five trials randomizing a total of 365 participants who all received antidepressants as co-intervention. All trials had high risk of bias. Four trials assessed ‘interpersonal psychotherapy’ and one trial ‘short psychodynamic supportive psychotherapy’. Meta-analysis showed that psychodynamic therapy significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference − 3.01 (95% confidence interval − 3.98 to − 2.03; P Limitations Our results are based on few trials with high risk of bias and a limited number of participants so our results may be questionable. Conclusions Adding psychodynamic therapy to antidepressants might benefit depressed patients, but the possible treatment effect measured on the Hamilton Rating Scale for Depression is small.
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the effect of interpersonal psychotherapy and other psychodynamic therapies versus treatment as usual in patients with major depressive disorder
PLOS ONE, 2011Co-Authors: Janus Christian Jakobsen, Jane Lindschou Hansen, Erik Simonsen, Christian GluudAbstract:Background: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment in systematic reviews. Methods/Principal Findings: Cochrane systematic review methodology with meta-analysis and trial sequential analysis of randomized trials comparing the effect of psychodynamic therapies versus ‘treatment as usual’ for major depressive disorder. To be included the participants had to be older than 17 years with a primary diagnosis of major depressive disorder. Altogether, we included six trials randomizing a total of 648 participants. Five trials assessed ‘interpersonal psychotherapy’ and only one trial assessed ‘psychodynamic psychotherapy’. All six trials had high risk of bias. Meta-analysis on all six trials showed that the psychodynamic interventions significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference 23.12 (95% confidence interval 24.39 to 21.86;P,0.00001), no heterogeneity) compared with ‘treatment as usual’. Trial sequential analysis confirmed this result. Discussion: We did not find convincing evidence supporting or refuting the effect of interpersonal psychotherapy or psychodynamic therapy compared with ‘treatment as usual’ for patients with major depressive disorder. The potential beneficial effect seems small and effects on major outcomes are unknown. Randomized trials with low risk of systematic errors and low risk of random errors are needed.