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Psychodynamic therapy: a poorly defined concept with questionable evidence
  1. Stefan G Hofmann
  1. Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA;

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ABSTRACT FROM: Leichsenring F, Luyten P, Hilsenroth M, et al. Psychodynamic therapy meets evidence-based medicine: a systematic review using updated criteria. Lancet Psychiatry 2015;2:648–60.

What is already known on this topic

Psychodynamic therapy (PDT) is widely practiced, but the empirical evidence for it is unclear.1 As relatively few well-controlled studies exist, some authors resort to meta-analyses that include numerous poorly controlled and underpowered clinical trials in order to support their claim that PDT is efficacious.2

Methods of the study

After reviewing the distinction between superiority, non-inferiority and equivalency trials, Leichsenring and colleagues conducted a traditional literature search, which identified 64 randomised controlled trials (RCTs) examining the efficacy of PDT in common mental health disorders. The authors then proceeded to provide their own interpretation of the literature by concluding that PDT is as effective as cognitive–behavioural therapy (CBT). However, this conclusion is unjustified given the poor or unknown quality of the studies included in this review.

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  • Funding Dr. Hofmann receives support from NIH/NCCIH (R01AT007257), NIH/NIMH (R01MH099021, R34MH099311, R34MH086668, R21MH102646, R21MH101567, K23MH100259), and the Department of the Army for work unrelated to the studies reported in this article. He receives compensation for his work as an advisor from the Palo Alto Health Sciences and Otsuka Digital Health, Inc., and for his work as a Subject Matter Expert from John Wiley & Sons, Inc. and SilverCloud Health, Inc. He also receives royalties and payments for his editorial work from various publishers.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.