Comparison of cognitive-behaviour therapy with psychoanalytic and psychodynamic therapy for depressed patients – A three-year follow-up study : Dorothea Huber, Johannes Zimmermann, Gerhard Henrich, Guenther Klug : 17th November 2012

by Julia Evans on November 17, 2012

Published in German : Vergleich von kognitiver Verhaltenstherapie mit analytischer und tiefenpsychologisch fundierter Psychotherapie bei depressiven Patienten – Eine Dreijahreskatamnese-Studie : Z Psychosom Med Psychother 58, p299–316 : 2012

Published in English : Comparison of cognitive-behaviour therapy with psychoanalytic and psychodynamic therapy for depressed patients – A three-year follow-up study : by www.internationalpsychoanalysis.net : available here  : 17th November 2012

Authors:

Dorothea Huber, Klinik und Poliklinik für PsychosomatischeMedizin und Psychotherapie, Technische Universität München, Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum Harlaching, International Psychoanalytic University (IPU), Berlin.

Johannes Zimmermann, Institut für Psychologie, Universität Kassel.

Gerhard Henrich, Klinik und Poliklinik für PsychosomatischeMedizin und Psychotherapie, Technische Universität München.

Guenther Klug, Klinik und Poliklinik für PsychosomatischeMedizin und Psychotherapie, Technische Universität München.

Summary:

Objective: The study investigates the effectiveness of long-term psychotherapies. Cognitive behaviour therapy was compared with psychoanalytic and psychodynamic therapy in the treatment of patients with a primary diagnosis of unipolar depression.

Method:

In a prospective, quasi-experimental design 100 patients were compared at pre- and post-treatment and three-year follow-up. Outcome measures were the Beck Depression Inventory and Global Severity Index for measuring symptoms, the Inventory of Interpersonal Problems and the Social Support Questionnaire for measurement of social-interpersonal functioning, and the INTREX Introject Questionnaire for measuring personality structure. Comparative effectiveness of the experimental groups was analyzed using mixed models.

Results:

We found significant outcome differences between psychoanalytic therapy and cognitive- behaviour therapy in depressive and global psychiatric symptoms, partly social-interpersonal and personality structure at three-year follow-up. Psychodynamic therapy was superior to cognitive-behaviour therapy in the reduction of interpersonal problems.

Conclusion:

Psychoanalytic therapy shows significantly longer-lasting effects compared to cognitive-behaviour therapy three years after termination of treatment, which is discussed as a dose-effect.

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Considering the restraint empirical knowledge up to now, we have formulated the following open research questions: Is (1) PA and (2) PD significantly different to CBT at three-year follow-up in terms of a) symptom improvement, b) social-interpersonal improvement, and c) change in personality structure?

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5. Conclusion

Given that a complex, multivariate psychosocial model is more appropriate than univariate explanations for relapse/recurrence of depressive disorder (Dobson & Dozois 2008), our results support the assumption that PA is superior to CBT, because on a symptomatic, on a social-interpersonal functioning level and on a personality structure level, the higher treatment dose and the more extended time frame of PA enhances more extended and stable benefits. PD, although achieving remarkably high benefits in the interpersonal dimension, is only partially capable to produce personality structures change enough to protect against relapse/recurrence after an extended follow-up interval. However, only a process-outcome approach applying mediation analyses can yield an empirically sound explanation for the research question under scrutiny.

NOTES

Thank you to Bruno de Florence for spotting this paper