Psychodynamic psychotherapy in the treatment of mood disorders.

摘要

PURPOSE OF REVIEW: This article summarizes recent studies of psychodynamic psychotherapy for mood disorders. It is important to note whether the therapy studied is adhering to the principles of psychodynamic psychotherapy, whether it is manual based or flexibly responsive to patient developments, whether it is short term or long term and whether it is combined with pharmacotherapy. RECENT FINDINGS: A review of recently published studies has found that all studies show a significant improvement in symptoms in patients who were depressed before treatment with psychodynamic psychotherapy. It is rare, however, for a study to meet the criteria of randomized clinical trials: use of treatment manuals and assured adherence, a sample of patients specifically diagnosed with depression and relevant measures. In one metaanalysis of studies meeting the above criteria, two of 17 studies included a sample with a diagnosis of depression, and short-term psychodynamic psychotherapy achieved similar results as other psychotherapies. Naturalistic studies show improvement with dynamic psychotherapy over time in both symptoms and dynamic measures, such as defense styles and frustration tolerance. SUMMARY: In the last year there were few randomized controlled studies specifically examining psychodynamic psychotherapy for mood disorders. Most evidence from naturalistic and various efficacy studies indicates that dynamic psychotherapy, with or without pharmacotherapy, is associated with improvement in symptoms and some character features. Longer follow-ups provide useful data for what can be a chronic or recurring illness. There are no data showing that psychodynamic therapy is more or less effective than other forms of psychotherapy.