The efficacy of adding short-term psychodynamic psychotherapy to antidepressants in the treatment of depression: A systematic review and meta-analysis of individual participant data

Ellen Driessen*, Jack J.M. Dekker, Jaap Peen, Henricus L. Van, Giuseppe Maina, Gianluca Rosso, Sylvia Rigardetto, Francesco Cuniberti, Veronica G. Vitriol, Ramon U. Florenzano, Antonio Andreoli, Yvonne Burnand, Jaime López-Rodríguez, Valerio Villamil-Salcedo, Jos W.R. Twisk, Pim Cuijpers

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review

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Abstract

Purpose: We examined the efficacy of adding short-term psychodynamic psychotherapy (STPP) to antidepressants in the treatment of depression by means of a systematic review and meta-analysis of individual participant data, which is currently considered the most reliable method for evidence synthesis. Results: A thorough systematic literature search resulted in 7 studies comparing combined treatment of antidepressants and STPP versus antidepressant mono-therapy (n = 3) or versus antidepressants and brief supportive psychotherapy (n = 4). Individual participant data were obtained for all these studies and totaled 482 participants. Across the total sample of studies, combined treatment of antidepressants and STPP was found significantly more efficacious in terms of depressive symptom levels at both post-treatment (Cohen's d = 0.26, SE = 0.10, p =.01) and follow-up (d = 0.50, SE = 0.10, p <.001). This effect was most apparent at follow-up and in studies examining STPP's specific treatment efficacy. Effects were still apparent in analyses that controlled for risk of bias and STPP quality in the primary studies. Conclusions: These findings support the evidence-base of adding STPP to antidepressants in the treatment of depression. However, further studies are needed, particularly assessing outcome measures other than depression and cost-effectiveness, as well as examining the relative merits of STPP versus other psychotherapies as added to antidepressants.

Original languageEnglish
Article number101886
Pages (from-to)1-10
Number of pages10
JournalClinical Psychology Review
Volume80
Early online date26 Jun 2020
DOIs
Publication statusPublished - Aug 2020

Keywords

  • Antidepressant medication
  • Combined treatment
  • Depression
  • Efficacy
  • Individual participant data meta-analysis
  • Short-term psychodynamic psychotherapy (STPP)

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