de Maat Saskia, de Jonghe Frans, Schoevers Robert, Dekker Jack
Mentrum Institute for Mental Health, Amsterdam, The Netherlands.
Harv Rev Psychiatry. 2009;17(1):1-23. doi: 10.1080/10673220902742476.
There is a gap in the research literature on the effectiveness of long-term psychoanalytic therapies (LPT).
To present a systematic review of studies dealing with LPT effectiveness and published from 1970 onward.
A systematic literature search for studies dealing with the effectiveness of individual LPT in ambulatory, adult patients. Data about the overall effectiveness of LPT, its impact on symptom reduction, and its effect on personality changes were pooled both at treatment termination and at follow-up, using effect sizes (ESs) and success rates.
We found 27 studies (n = 5063). Psychotherapy yielded large mean ESs (0.78 at termination; 0.94 at follow-up) and high mean overall success rates (64% at termination; 55% at follow-up) in moderate/mixed pathology. The mean ES was larger for symptom reduction (1.03) than for personality change (0.54). In severe pathology, the results were similar. Psychoanalysis achieved large mean ESs (0.87 at termination; 1.18 at follow-up) and high mean overall success rates (71% at termination; 54% at follow-up) in moderate pathology. The mean ES for symptom reduction was larger (1.38) than for personality change (0.76).
Our data suggest that LPT is effective treatment for a large range of pathologies, with moderate to large effects.
关于长期精神分析疗法（LPT）有效性的研究文献存在空白。
对1970年及以后发表的有关LPT有效性的研究进行系统综述。
对关于门诊成年患者个体LPT有效性的研究进行系统文献检索。使用效应量（ESs）和成功率，汇总治疗结束时和随访时LPT的总体有效性、其对症状减轻的影响及其对人格改变的影响的数据。
我们找到了27项研究（n = 5063）。在中度/混合性病理状态下，心理治疗产生了较大的平均效应量（治疗结束时为0.78；随访时为0.94）和较高的平均总体成功率（治疗结束时为64%；随访时为55%）。症状减轻的平均效应量（1.03）大于人格改变的平均效应量（0.54）。在严重病理状态下，结果相似。在中度病理状态下，精神分析产生了较大的平均效应量（治疗结束时为0.87；随访时为1.18）和较高的平均总体成功率（治疗结束时为71%；随访时为54%）。症状减轻的平均效应量（1.38）大于人格改变的平均效应量（0.76）。
我们的数据表明，LPT是治疗多种病理状态的有效方法，具有中度到较大的效果。
