Jakobsen Thorsten, Rudolf Gerd, Brockmann Josef, Eckert Jochen, Huber Dorothea, Klug Günther, Grande Tilman, Keller Wolfram, Staats Hermann, Leichsenring Falk
Institut für Psychotherapieforschung und Qualitätssicherung, Heidelberg, Germany.
Z Psychosom Med Psychother. 2007;53(2):87-110. doi: 10.13109/zptm.2007.53.2.87.
In the present paper, data from four German studies on the efficacy of outpatient psychoanalytic long-term psychotherapy were examined for symptom reduction (SCL-90-R) and reduction of interpersonal problems (IIP-D). Specifically, the research question addressed the efficacy of long-term therapy in specific diagnostic groups and was was compared with that of a parallel group who underwent shorter-term psychodynamic therapy.
Data from four German studies addressing the efficacy of outpatient psychoanalytic long-term therapy were collected. Evaluation of these data was carried for specific diagnostic groups allowing for comorbid diagnoses. The effects of psychoanalytic therapy were assessed by pre-post and pre-follow-up comparisons using paired t-tests. Additionally, effect sizes were calculated. Psychoanalytic long-term psychotherapy and shorter-term psychodynamic therapy were compared by using a repeated measure ANOVA: Pretreatment vs. posttreatment/follow-up (two-levels) with the between subject factor "therapy conditions" (two levels).
The results showed that in terms of improvement of symptoms and interpersonal problems, psychoanalytic long-term therapy was at least as effective as shorter term psychodynamic therapy with regard to the following ICD-10 diagnostic groups: affective disorders (F3), anxiety disorders (F40; F41; F42), personality disorders (F60; F61; F62), and a group of mixed neurotic disorders (F43; F50; F51; F1; F55). Effect sizes were large and remained stable at follow-up.
The authors emphasize the clinical relevance of the examined diagnostic groups and relatively large effects achieved by the psychoanalytic treatment. Furthermore, the occurrence of comorbid diagnoses and their consequences are discussed. The authors stress that the specific effects of psychoanalytic therapy can only be very insufficiently tapped by the outcome measures referring to symptoms and interpersonal problems.
在本文中，对四项关于门诊精神分析长期心理治疗疗效的德国研究数据进行了检查，以评估症状减轻情况（症状自评量表-90修订版[SCL-90-R]）和人际问题减少情况（人际问题问卷-简版[IIP-D]）。具体而言，研究问题聚焦于长期治疗在特定诊断组中的疗效，并与接受短期心理动力治疗的平行组进行比较。
收集了四项关于门诊精神分析长期治疗疗效的德国研究数据。针对允许合并诊断的特定诊断组对这些数据进行了评估。通过配对t检验进行治疗前后及治疗前与随访前的比较，以评估精神分析治疗的效果。此外，还计算了效应量。使用重复测量方差分析对精神分析长期心理治疗和短期心理动力治疗进行比较：治疗前与治疗后/随访（两个水平），组间因素为“治疗条件”（两个水平）。
结果显示，在症状和人际问题改善方面，对于以下国际疾病分类第十版（ICD-10）诊断组，精神分析长期治疗至少与短期心理动力治疗同样有效：情感障碍（F3）、焦虑障碍（F40；F41；F42）、人格障碍（F60；F61；F62）以及一组混合性神经症障碍（F43；F50；F51；F1；F55）。效应量较大，且在随访时保持稳定。
作者强调了所研究诊断组的临床相关性以及精神分析治疗所取得的相对较大的效果。此外，还讨论了合并诊断的发生情况及其后果。作者强调，仅通过针对症状和人际问题的结局指标，只能非常不充分地挖掘精神分析治疗的特定效果。
