Skip to main content
Article thumbnail
Location of Repository

Psychoanalytic and psychodynamic therapies for depression. The evidence base.

By David Taylor

Abstract

David Taylor, a consultant psychotherapist at the Tavistock & Portman NHS Foundation Trust (120 Belsize Lane, London NW3 5BA, UK. Email: dtaylor@tavi-port.nhs.uk), is the clinical lead of the Tavistock Adult Depression Study (a randomised controlled trial of 60 sessions of weekly psychoanalytic psychotherapy v. treatment as usual for patients with chronic, refractory depression). He is a training and supervising psychoanalyst at the Institute of Psychoanalysis. \ud \ud This article argues that the current approach to guideline development for the treatment of depression is not supported by the evidence: clearly depression is not a disease for which treatment efficacy is best determined by short-term randomised controlled trials. As a result, important findings have been marginalised. Different principles of evidence-gathering are described. When a wider range of the available evidence is critically considered the case for dynamic approaches to the treatment of depression can be seen to be stronger than is often thought. Broadly, the benefits of short-term psychodynamic therapies are equivalent in size to the effects of antidepressants and cognitive–behavioural therapy (CBT). The benefits of CBT may occur more quickly, but those of short-term psychodynamic therapies may continue to increase after treatment. There may be a ceiling on the effects of short-term treatments of whatever type. Longer-term psychodynamic treatments may improve associated social, work and personal dysfunctions as well as reductions in depressive symptoms

Topics: Depression, Brief Therapies
Publisher: The Royal College of Psychiatrists
Year: 2008
DOI identifier: 10.1192/apt.bp.107.004382
OAI identifier: oai:repository.tavistockandportman.ac.uk:236

Suggested articles

Citations

  1. (2002). A meta (re)analysis of the effects of cognitive therapy versus ‘other therapies’ for depression. doi
  2. (1997). A meta analysis of outcome studies comparing bona fide psycho therapies: empirically, ‘all must have prizes’. doi
  3. (2001). A systematic review of controlled trials of the effectiveness and cost effectiveness of brief psychological treatments for depression.
  4. (2008). Advances in Psychiatric Treatment doi
  5. (1991). Affective disorders. doi
  6. (1987). Comparative effectiveness of psychotherapies for depressed elders. doi
  7. (2001). Comparative effects of shortterm psychodynamic psychotherapy and cognitive–behavioural therapy in depression: a metaanalytic approach. doi
  8. (1991). Comparative effects of shortterm psychodynamic psychotherapy: a metaanalysis. doi
  9. (1975). Comparative studies of psychotherapies. Is it true that “everybody has won and all must have prizes”? doi
  10. (2003). Controlled trial of the short and longterm effect of psychological treatment of postpartum depression. 1: Impact on maternal mood. doi
  11. (1991). Depressive illness: diagnostic issues.
  12. (2002). Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). doi
  13. (1994). Effects of treatment duration and severity of depression in the maintenance of gains following cognitive/behavioural and psychodynamic/interpersonal psychotherapy. doi
  14. (1990). Factors associated with 1year outcome of major depression in the community. doi
  15. (1994). Future imperfect: longterm outcome of depression. doi
  16. (1994). Historical overview of outcome of depression.
  17. (2008). http://apt.rcpsych.org/ 413 Psychotherapies for depression
  18. (2002). Longterm treatments from the perspectives of the former patients.
  19. Love, Guilt and Reparation and Other Works 1921–1945.
  20. (1940). Mourning and its relation to manic–depressive states. Reprinted
  21. (1917). Mourning and melancholia. Reprinted
  22. (2004). National Collaborating Centre for Mental Health doi
  23. (1998). Outcome assess ment: from conceptualization to implementation. doi
  24. (2001). Outcome of patients in longterm psychoanalytical treatments.
  25. (1994). Patterns of symptomatic recovery in psychotherapy. doi
  26. (1991). Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. doi
  27. (2004). Psycho therapy alone and combined with pharmacotherapy in the treatment of depression.
  28. (1990). Psycho therapy for the treatment of depression: a comprehensive review of controlled outcome research. doi
  29. (2001). Psychoanalysis and cognitive behaviour therapy – rival paradigms or common ground? doi
  30. (2005). Psychodynamic psychotherapies. Evidencebased practice and clinical wisdom. doi
  31. (2002). Psychodynamic psychotherapy and clomipramine in the treatment of major depression. doi
  32. (1992). Psychotherapy outcome research: implications for integrative and eclectic theories.
  33. (2002). Random ised controlled trials investigating pharmacological and psychological interventions for treatmentrefractory depression. Systematic review. doi
  34. (2008). Random ized trial on the effectiveness of longand shortterm psychodynamic psychotherapy and solutionfocused therapy on psychiatric symptoms during a 3year follow up.
  35. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational followup.
  36. (2006). Short term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews, doi
  37. (1995). Shortterm dynamically oriented psychotherapy: a review and metaanalysis.
  38. (1997). The clinical course of unipolar major depressive disorders. doi
  39. (2005). The effectiveness of psychological treatments for treatment resistant depression: a systematic review. doi
  40. (1998). The effects of detection and treatment on the outcome of major depression in primary care: a naturalistic study in 15 cities.
  41. (1992). The efficacy of brief dynamic psycho therapy: a metaanalysis.
  42. (1993). The efficacy of psychological, education, and behavioral treatment: confirmation from metaanalysis. doi
  43. (2004). The efficacy of shortterm psychodynamic psychotherapy in specific psychiatric disorders. A metaanalysis. doi
  44. (2004). The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials. doi
  45. (2004). The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130, 631–663.Advances in Psychiatric Treatment doi
  46. (2003). The epidemiology of major depressive disorder: results from the national comorbidity survey replication. doi
  47. (1988). The longterm outcome of Maudsley depressives. doi
  48. (2005). The Origins and Course of Common Mental Disorders. doi
  49. (1999). The researcher’s own therapy allegiances: a “wild card” in comparisons of treatment efficacy. doi
  50. (1997). The role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder. doi
  51. (1994). The time course of untreated major depression: uniformity across episodes and samples. doi
  52. (1984). The Zurich Study II. The continuum from depressive to pathological mood swings. doi
  53. (1985). The Zurich Study. VI. A continuum from depression to anxiety disorders? doi
  54. (1976). Toward the Validation of Dynamic Psychotherapy. doi
  55. (1997). Treatment of major depression with psychotherapy or psychotherapy– pharmacotherapy combinations. doi
  56. (2000). Varieties of long term outcome among patients in psychoanalysis and long term psychotherapy. A review of findings in the Stockholm Outcome of Psychoanalysis Project (STOPP). doi
  57. (2004). What Works for Whom? A Critical Review of Psychotherapy Research (2nd edn).

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.