Winston 1994.
Methods | RCT with 3 parallel conditions | |
Participants | 93 psychiatric outpatients Inclusion criteria: aged 18‐60 years; evidence of at least 1 close personal relationship; no evidence of psychosis, organic brain syndrome, or mental retardation; no active DSM‐III‐R axis III medical diagnosis; no evidence of current substance abuse; no acute suicidal behaviour; no history of violent behaviour or destructive impulse control problems; and no use of psychotropic medications, such as lithium, neuroleptics or antidepressants in the past year Exclusion criteria: axis II diagnoses of schizoid, paranoid, schizotypal, narcissistic and borderline personality disorders |
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Interventions | Intervention 1: STDP, manualised, based on Davanloo 1980 Intervention 2: BAP based on Pollack 1991 Control: waiting list (mean wait‐list time 14.9 weeks) 24 therapists (13 for STDP, 11 for BAP), mean experience 11.6 years, mean number of sessions, both techniques combined, 40.3 All sessions videotaped, adherence rated through systematic scales | |
Outcomes | Assessed at pre‐treatment and 1 month post‐treatment: GSI of SCL‐90‐R, SAS, target complaints rating 6 months post: target complaints | |
Notes | SCL‐90 and SAS data used in review STDP and BAP entered separately as contrasting forms of STPP models |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Comment: insufficient information |
Allocation concealment (selection bias) | Unclear risk | Comment: insufficient information |
Blinding (performance bias and detection bias) All outcomes | Low risk | Comment: self report ratings (SCL‐90, SAS) considered low risk of bias No psychotherapist was blinded to the treatment delivered Blinding participants to treatment group not possible |
Incomplete outcome data (attrition bias) All outcomes | High risk | Quote: "the patients who dropped out of the study were similar to the treated patients in both demographic characteristics and diagnosis, although no formal analyses were conducted because of the small number of dropouts" Comment: 6/31 participants in STDP dropped out vs. 2/32 in BAP: this is considered significant enough to warrant analysis to rule out attrition bias |
Selective reporting (reporting bias) | Unclear risk | Comment: insufficient information to permit judgement. No published report on pre‐specified outcomes |
Other bias | Unclear risk | Comment: insufficient information to permit judgement |
BAI: Beck Anxiety Inventory; BAP: brief adaptive psychotherapy; BDI: Beck Depression Inventory; BDT: brief dynamic therapy; BSI: Brief Symptom Inventory; CBT: cognitive behavioural therapy; CGI: Clinical Global Impressions; CGI‐I: Clinical Global Impression ‐ Improvement scale; CGI‐S: Clinical Global Impression ‐ Severity scale; CPRS: complex regional pain syndrome; DSM‐III: Diagnostic and Statistical Manual of Mental Disorders ‐ third edition; DSM‐IV: Diagnostic and Statistical Manual of Mental Disorders ‐ fourth edition; EPDS: Edinburgh Postnatal Depression Scale; GAF: Global Assessment of Functioning; GAS: Global Assessment Scale; GP: general practitioner; GSI: Global Severity Index; HAI: Health Anxiety Inventory; HAM‐A: Hamilton Anxiety Rating Scale; HAM‐D: Hamilton Depression Rating Scale; HDRS: Hamilton Depression Rating Scale; HQ: Health Questionnaire; hr: hour; IBS: irritable bowel syndrome; ICD‐10: International Statistical Classification of Diseases and Health Related Problems 10th Revision; IIP: Inventory of Interpersonal Problems; ISTDP: intensive short‐term dynamic psychotherapy; ITT: intention to treat; LWASQ: Lehrer Woolfolk Anxiety Symptom Questionnaire; MDD: major depressive disorder; min: minute; OCD: obsessive‐compulsive disorder; OQ: Outcome Questionnaire; PAAS: Panic Attack and Anxiety Scale; PBT: psychodynamic body therapy; PHQ: Patient Health Questionnaire; PIT: psychodynamic interpersonal therapy; PPD: postpartum depression; PTO: Post‐traumatic Stress Treatment Outcome scale; PTSD: post‐traumatic stress disorder; QLDS: Quality of Life Depression Scale; QOR Quality of Object Relations; RCT: randomised controlled trial; SAS: Social Adjustment Scale; SCID: Structured Clinical Interview for DSM‐IV Disorders; SCL‐90: Symptom Checklist‐90; SCL‐90‐GSI: Symptom Checklist‐90 Global Severity Index; SCL‐90‐R: Symptom Checklist‐90 ‐ Revised; SCORAD: Scoring of Atopic Dermatitis Index; SF‐36 MCS: 36‐item Short Form ‐ Mental Component Summary; SF‐36 PCS: 36‐item Short Form ‐ Physical Component Summary; SF‐36: 36‐item Short Form; SPRS: Sydney Psychosocial Reintegration Scale; SPSP: short psychodynamic supportive psychotherapy; SSIAM: Structured and Scaled Interview to Assess Maladjustment; STAI: State‐trait Anxiety Inventory; STDP: short‐term dynamic psychotherapy; STPP: short‐term psychodynamic psychotherapy; TAU: treatment as usual; TLP: time‐limited psychotherapy; VAS: visual analogue scale; WHO: World Health Organization; Y‐BOCS: Yale‐Brown Obsessive Compulsive Scale.