Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis

Br J Psychiatry. 2011 Jul;199(1):15-22. doi: 10.1192/bjp.bp.110.082776.


Background: Dose-effect relationship data suggest that short-term psychotherapy is insufficient for many patients with chronic distress or personality disorders (complex mental disorders).

Aims: To examine the comparative efficacy of long-term psychodynamic psychotherapy (LTPP) in complex mental disorders.

Method: We conducted a meta-analysis of controlled trials of LTPP fulfilling the following inclusion criteria: therapy lasting for at least a year or 50 sessions; active comparison conditions; prospective design; reliable and valid outcome measures; treatments terminated. Ten studies with 971 patients were included.

Results: Between-group effect sizes in favour of LTPP compared with less intensive (lower dose) forms of psychotherapy ranged between 0.44 and 0.68.

Conclusions: Results suggest that LTPP is superior to less intensive forms of psychotherapy in complex mental disorders. Further research on long-term psychotherapy is needed, not only for psychodynamic psychotherapy, but also for other therapies.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease
  • Humans
  • Long-Term Care
  • Mental Disorders / therapy*
  • Personality Disorders / therapy
  • Psychoanalytic Therapy
  • Psychotherapeutic Processes
  • Psychotherapy / methods*
  • Randomized Controlled Trials as Topic
  • Time Factors
  • Treatment Outcome