Table 1.
Characteristics of studies included in the systematic review.
| Study | Baseline characteristics | Intervention | Outcome measure | Area of outcome | ||||
|---|---|---|---|---|---|---|---|---|
| Age (SD) | Sex (Female/Male) | Diagnosis | Treatment and control condition | Number of patients | Sessions | |||
| Randomized controlled trial (RCT) | ||||||||
| Ajilchi et al. (2016) (Iran) | 19-40 (84.4%19-29) | 9/23 | Major depressive disorder (MDD) | Intensive short-term dynamic psychotherapy (ISTDP) | 16 | 15 | Beck depression inventory (BDI-II; Beck et al., 1996) | Primary outcome: depression |
| Wait-list | 16 | Wisconsin Card Sorting Test (WCST; Heaton et al., 1993) Stroop Task (MacLeod, 1991) | Secondary outcome: executive functioning | |||||
| Bachar et al. (1999) (Israel) | 24.1 (3.3) | 33/0 | Bulimia Nervosa (BN) and Anorexia (AN) | Self- psychological treatment (SPT) | 14 | 48 | DSM symptomatology scale for anorexia and bulimia (DSM SS), EAT 26 (Eating attitudes test; Garner et al., 1982) | Primary outcome: general psychiatric symptoms |
| Cognitive orientation treatment (COT) | 12 | 48 | BSI (Brief symptom inventory; Derogatis and Spencer, 1982) | |||||
| Control/nutritional counseling only (C/NC) | 7 | 12 | Selves questionnaire (Higgins, 1987) | |||||
| Symptom Checklist-90-R (SCL-90-R; Derogatis and Unger, 2010) | Secondary outcome:symptomatic remission | |||||||
| Cooper et al. (2003) (United Kingdom) | 27.69 (5.36) | 193/0 | Post-partum depression | Counseling | 193 | 18 | Edinburgh Postnatal Depression Scale, (EPDS; Cox et al., 1987); Structured Clinical Interview for DSM-III-R (SCID; Spitzer et al., 1992); Therapist Rating Scale (Silove et al., 1990) | Primary outcome: maternal mood |
| Cognitive behavioral therapy (CBT) | ||||||||
| Psychodynamic psychotherapy | Secondary outcomes: depression therapist adherence | |||||||
| Control | ||||||||
| Dare et al. (2001) (Denmark) | 26.3 (6.7) | 82/2 | Anorexia nervosa (AN) | Focal psychodynamic psychotherapy (FPP) | 12 | 24.9 (13.0) | Morgan-Russell psychiatric interview (Morgan and Hayward, 1988). | Primary outcome: weight gain |
| Cognitive-analytic therapy (CAT) | 13 | 12.9 (7.0) | Body mass index (BMI) | |||||
| Family therapy (FT) | 16 | 13 (8.6) | ||||||
| Low contact, `routine' treatment (LRT) | 13 | 10.9 (0.5) | ||||||
| Doering et al. (2010) (Austria, Germany) | 27.46 (6.8) | 104 | Borderline personality disorder (BPD) | Transference-focused psychotherapy (TFP) | 104 | 48.5 | German version of the Cornell Interview for Suicidal and Self-harming behavior (CISSB; Clarkin, 1998a); SCID-I and -II (American Psychiatric Association, 1994) |
Primary outcomes: Number of participants who dropped out; Suicide attempts |
| Global Assessment of Functioning Scale (GAF; American Psychiatric Association, 1994) BDI; State–Trait Anxiety Inventory (STAI, Spielberger et al., 1999); BSI; Cornell Revised Treatment History Inventory (CRTHI; Clarkin, 1998b) |
Secondary outcomes: DSM–IV diagnostic criteria for borderline personality disorder and number of comorbid Axis I and II diagnoses Psychosocial functioning General psychopathology Self-harming behavior Psychiatric in-patient admissions. |
|||||||
| Garner et al. (1993) (Canada) | 24.15 (4.19) | 50/0 | Bulimia nervosa (BN) | Supportive-expressive therapy (SET) | 50 | 19 | Eating attitude test; Eating disorder examination (Cooper and Fairburn, 1987); |
Primary outcomes: Frequency of vomiting; Binge eating episodes |
| CBT | Eating disorder inventory (Garner, 1991); SCL-90-R; Borderline syndrome index (Conte et al. 1980); Rosenberg-self esteem scale (Rosenberg, 1965; BDI; Millon Clinical Multiaxial Inventory) (Millon, 1982); Social adjustment scale-self-report (Weissman et al., 1978). | |||||||
| Moghadam et al. (2015) (Iran) | 0/38 | Social phobia | Short-term dynamic psychotherapy | 13 | 25 | Social Phobia Inventory (Connor et al., 2000; SPIN) | Primary outcome: Social phobia | |
| Sertraline | 11 | 12 weeks | Global Clinical Impression-Severity and Improvement (Zaider et al., 2003; CGI-S, CGI-I) | Secondary outcomes: General psychopathology |
||||
| Waiting list | 14 | GAF Scale | ||||||
| Mowlaie et al. (2018) (Iran) | 20.93 (1.50) | 30/0 | Adult separation anxiety disorder (ASAD) | Brief empathic psychotherapy (BEP) | 30 | 12 | Adult Separation Anxiety Questionnaire (ASA-27; Manicavasagar et al., 2003) | Primary outcomes: Anxiety Depression |
| Affect phobia therapy (APT) | Depression, anxiety, and stress scale-21 (DASS-21; Lovibond and Lovibond, 1995) | |||||||
| Structured clinical interview for separation anxiety symptoms (SCI-SAS; Cyranowski et al., 2002) | ||||||||
| GAF Scale | ||||||||
| Orvati Aziz et al. (2020) Iran | 24.92 (5.25) | 91.7% female in the integrative therapy group | Generalized anxiety disorder | Integrative therapy (short-term psychodynamic psychotherapy and cognitive-behavioral therapy) cognitive-behavioral therapy | 36 | 15 | Hamilton rating scale for anxiety (HRSA; Hamilton, 1959) | Primary outcomes: Symptoms of generalized anxiety Depression |
| Control (83.3%) Cognitive behavioral (75%) |
BDI | |||||||
| Poulsen et al. (2014) and Katznelson et al. (2020) (Denmark) | 25.8 (4.9) | 69/1 | BN | Psychoanalytic psychotherapy (PPT) | 70 | 72.3 (10.6) | Eating Disorder Examination interview (Fairburn and Cooper, 1993); Present State Examination (The SCAN Advisory Group, 1994); SCL-90-R; BDI-II, STAI |
Primary outcome:cessation of binge eating and purging secondary outcomes: eating disorder psychopathology; general psychopathology therapeutic alliance |
| CBT | 22 | Vanderbilt Therapeutic Alliance Scale (VTAS; Hartley and Strupp, 1983) Adult Attachment Interview (AAI; George et al., 1996) |
Attachment relationships | |||||
| Reflective Function Scale (Fonagy et al., 2016) | ||||||||
| Rahmani et al. (2020) (Kurdistan) | 23.07 (3.26) | 22/19 | Social anxiety disorder (SAD) | Intensive short-term dynamic psychotherapy (ISTDP) | 41 | 10 | DSM-5 criteria for SAD; Liebowitz Social Anxiety Scale (Liebowitz, 1987) | Primary outcomes: target symptom (fear and avoidance) |
| Stefini et al. (2017) (Germany) | 18.7 (1.9) | 81/0 | BN | Psychodynamic therapy (PDT) | 42 | 33.0 (25.3) | SCID-I and SCID-II for the DSM-IV Eating Disorder Examination Interview (EDE) |
Primary Outcome: Remission from BN |
| CBT | 39 | 40.7 (22.2) | SCL-90-R EDE Questionnaire (EDE-Q) | Secondary outcomes: severity of BN symptoms; psychiatric comorbidities; overall severity of mental symptoms | ||||
| Zipfel et al. (2014), Egger et al. (2016), Herzog et al. (2022) (Germany) | 27.7 | 242/0 | AN | FPT | 80 | NR | BMI; EDI; Structured Interview for Anorexia and Bulimia Nervosa for DSM-IV and ICD-10 (SIAB-EX, Fichter et al. 1991) |
Primary outcome: Weight gain |
| CBT | 80 | |||||||
| Optimized treatment as usual (TAU-O) | 82 | NR | Secondary outcomes: rate of recovery (combination of weight gain and eating disorder-specific psychopathology) |
|||||
| Walton et al. (2020) (New South Wales, Australia) | 26.6 (7.8) | 125/37 | BPD | Dialectical behavior therapy (DBT) | 162 | 112 | Combined outcome of any episode of suicidal and non-suicidal self-injury (SASI)-Count (Linehan and Comtois, 1996; Linehan et al., 2011) BDI-II | Primary Outcomes: Number of suicidal attempts and non- suicidal self-injurious (NSSI) episodes Depression severity |
| Conversational model (CM) | 112 | Borderline Personality Disorder Severity Index (BPDSI-IV; Arntz et al., 2003). Inventory of Interpersonal Problems (IIP; Horowitz et al., 1988); Dissociative Experiences Scale (DES; Bernstein and Putman, 1986); Sense of Self Inventory (SSI; Basten, 2008); |
Secondary Outcomes: BPD Severity, Interpersonal problems, Dissociation, Sense of self, Mindfulness, Emotion regulation | |||||
| Kentucky Inventory of Mindfulness Skills (KIMS; Baer et al., 2004); The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) | ||||||||
| Naturalistic studies | ||||||||
| Baruch and Fearon (2002), Baruch (1995), Baruch et al. (1998) (United Kingdom) | 19.7 (3.2) | 102/49 | Principal ICD-10 diagnosis (World Health Organization, 1992): mood disorder (n = 53%) Conduct disorder (11%) Neurotic disorder, stress-related, or somatoform disorder (20%) Personality disorder (8%) |
Psychodynamic psychotherapy | 151 | 66 | Young adult self report form (YASR; Achenbach, 1997) | Primary outcome: internalising and externalising problems |
| Gerber et al., 2004 (United Kingdom) | 22.8 (2.1) | 17/8 | Depression, anxiety, and personality disorders DSM-III-R diagnoses | Psychodynamic psychotherapy | 11 | 6 months to 8 years long | BDI STAI-T SCID-II |
Primary outcomes: anxiety and depression symptoms |
| Psychoanalysis | 14 | Schedule for Affective Disorders and Schizophrenia (SADS; Endicott and Spitzer, 1987) | Secondary outcomes: DSM diagnoses Axis I and II | |||||
| Harder et al. (2014) and Rosenbaum et al. (2012) (United Kingdom) | 24 | 88/181 | First-episode schizophrenia spectrum disorder | Supportive psychodynamic psychotherapy (SPP) | 119 | 3 years | Operational criteria checklist for psychotic illness (OPCRIT; McGuffin et al., 1991) GAF-symptom, GAF-function | Primary outcome: Psychosocial functioning |
| (SSD) | Standard Treatment (ST) | 150 | Strauss-Carpenter scale (Strauss and Carpenter, 1974, 1977) Positive and negative syndrome scale (PANSS; Kay et al., 1987) | Secondary outcome: target symptoms | ||||
| Nemirovski Edlund and Carlberg (2016) (Sweden) | 19.17 (2.45) | 166/52 | Mood disorder (n = 69) Anxiety disorder (n = 59) Other diagnoses (n = 69) |
Psychodynamic psychotherapy | 218 | 43 (50) | SCL-90 children’s global assessment scale (CGAS, Shaffer et al., 1983) GAF | Primary outcomes: general functioning and symptoms severity |
| Falkenström (2010) (Sweden) | Sample 1: 19.1 (2.9) | 312/104 | Mood (30%) and anxiety (24%) disorders | Psychodynamic | 416 | 23 (19) | SCL-90; IIP; GAF | Primary outcomes: defense mechanisms and copying functioning |
| Sample 2: 19 (1.8) | 83/18 | Personality disorder | Psychotherapy | 101 | ||||
| Kramer et al. (2010, 2014) (Switzerland) | 24 (3.86) | 26/6 | Adjustment disorder with depressed mood personality disorder cluster B | Short-term dynamic psychotherapy (STDP) | 32 | 40 | Defense mechanism rating scales (Perry, 1990) and coping action patterns (Perry et al., 2005) | Primary outcomes: general functioning and symptoms severity |
| SCL-90-R; BDI–II; | Secondary outcomes: depression therapeutic alliance affective meaning states | |||||||
| Helping Alliance Questionnaire—II (HAq–II; Alexander and Luborsky, 1986) | ||||||||
| Classification of affective meaning states (CAMS; Pascual-Leone and Greenberg, 2005) | ||||||||
|
Philips et al. (2006), Lindgren et al. (2010), Werbart et al. (2017) Sweden (Young adult psychotherapy project) |
22 (2.2) | 98/36 | Personality disorders; non diagnosed depressive mood, anxiety, problems in the relationship to parents, and low self-esteem | Individual psychoanalytic psychotherapy (IPP) | 92 | 15 months | DSM-IV and ICD-10 personality questionnaire (DIP-Q; Ottosson et al., 1995) SCL-90; BSI; Self-rated health (SRH; Bjørner et al., 1996) |
Primary outcomes: personality disorder |
| Group psychoanalytic psychotherapy (GPP) | 42 | GAF; IIP; The structural analysis of social behavior intrex questionnaire (SASB; Benjamin, 1988) The differentiation-relatedness of self and object representations scale (DRS; Blatt and Auerbach, 2001) HAq-II |
Secondary outcomes: target symptoms, psychosocial function | |||||
| Riva Crugnola et al. (2020) (Italy) | 23.29 (4.89) | 96/28 | N/A Self-referred University students |
Brief psychodynamic counselling | 124 | 4 | SCL-90-R | Primary outcome: severity of psychopathological symptoms |
| Attachment style questionnaire (ASQ; Feeney et al., 1994; Italian version: Fossati et al., 2003) | Secondary outcome: attachment style | |||||||
AAI, adult attachment interview; AN, anorexia nervosa; APT, affect phobia therapy; ASAD, adult separation anxiety disorder; ASA-27, adult separation anxiety questionnaire; ASQ, attachment style questionnaire; BEP, brief empathic psychotherapy; BN, bulimia nervosa; BDI-II, beck depression inventory; BMI, body mass index; BSI, brief symptom inventory; BPD, borderline personality disorder; BPDSI-IV, borderline personality disorder severity index; CAMS, classification of affective meaning states; CGAS, children’s global assessment scale; CAT, cognitive- analytic therapy; CBT, cognitive behavioral therapy; CISSB, cornell interview for suicidal and self-harming behavior; CM, conversational model; C/NC, control/nutritional counseling only; COT, cognitive orientation treatment; CRTHI, Cornell revised treatment history inventory; DASS-21, depression, anxiety, and stress scale-21; DBT, dialectical behavior therapy; DERS, the difficulties in emotion regulation scale; DES, dissociative experiences scale; DIP-Q, DSM-IV and ICD-10 personality questionnaire; DRS, differentiation-relatedness of self and object representations scale; DSM, diagnostic and statistical manual of mental disorders; EAT 26, eating attitudes test; EPDS, Edinburgh postnatal depression scale; FPP, focal psychodynamic psychotherapy; FT, family therapy; GAF, global assessment of functioning; GSI, global severity index; GPP, group psychoanalytic psychotherapy; HAq–II, helping alliance questionnaire—II; HRSA, Hamilton rating scale for anxiety; KIMS, Kentucky inventory of mindfulness; IIP, inventory of interpersonal problems; IPP, individual psychoanalytic psychotherapy; ISTDP, intensive short-term dynamic psychotherapy; LRT, low contact, `routine’ treatment; MDD, major depressive disorder; NSSI, non- suicidal self-injurious; OPCRIT, operational criteria checklist for psychotic illness; PANSS, positive and negative syndrome scale; PPT, psychoanalytic psychotherapy; SAD, social anxiety disorder; SADS, schedule for affective disorders and schizophrenia; SASB, structural analysis of social behavior intrex questionnaire; SASI, suicidal and non-suicidal self-injury; SCID, structured clinical interview for DSM; SCI-SAS, structured clinical interview for social anxiety symptoms; SCL-90, symptom checklist-90; SET, supportive-expressive therapy; SIAB-EX, structured interview for anorexia and bulimia nervosa; SPIN, social phobia inventory; SPP, supportive psychodynamic psychotherapy; SPT, self- psychological treatment; SSD, schizophrenia spectrum disorder; SSI, sense of self inventory; ST, standard treatment; STAI, state–trait anxiety inventory; STDP, short-term dynamic psychotherapy; TAU-O, optimized treatment as usual; TFP, transference-focused psychotherapy; VTAS, Vanderbilt therapeutic alliance scale; WCST, Wisconsin card sorting test; YASR, young adult self report form.