Huber Dorothea, Zimmermann Johannes, Henrich Gerhard, Klug Guenther
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Technische Universität München, D-81545 München, Germany.
Z Psychosom Med Psychother. 2012;58(3):299-316. doi: 10.13109/zptm.2012.58.3.299.
The study investigates the effectiveness of long-term psychotherapies. Cognitive-behaviour therapy was compared with psychoanalytic and psychodynamic therapy in the treatment of patients with a primary diagnosis of unipolar depression.
In a prospective, quasi-experimental design 100 patients were compared at pre- and post-treatment and three-year follow-up. Outcome measures were the Beck Depression Inventory and Global Severity Index for measuring symptoms, the Inventory of Interpersonal Problems and the Social Support Questionnaire for measurement of social-interpersonal functioning, and the INTREX Introject Questionnaire for measuring personality structure. Comparative effectiveness of the experimental groups was analyzed using mixed models.
We found significant outcome differences between psychoanalytic therapy and cognitive-behaviour therapy in depressive and global psychiatric symptoms, partly social-interpersonal and personality structure at three-year follow-up. Psychodynamic therapy was superior to cognitive-behaviour therapy in the reduction of interpersonal problems.
Psychoanalytic therapy shows significantly longer-lasting effects compared to cognitive-behaviour therapy three years after termination of treatment, which is discussed as a dose-effect.
本研究调查长期心理治疗的有效性。将认知行为疗法与精神分析和心理动力疗法相比较，用于治疗以单相抑郁为主要诊断的患者。
采用前瞻性、准实验设计，在治疗前、治疗后及三年随访期对100名患者进行比较。结果测量指标包括用于测量症状的贝克抑郁量表和总体严重程度指数、用于测量社会人际功能的人际问题量表和社会支持问卷，以及用于测量人格结构的INTREX内摄问卷。使用混合模型分析实验组的相对有效性。
我们发现，在三年随访期，精神分析疗法与认知行为疗法在抑郁和总体精神症状、部分社会人际和人格结构方面存在显著的结果差异。心理动力疗法在减少人际问题方面优于认知行为疗法。
治疗结束三年后，与认知行为疗法相比，精神分析疗法显示出显著更持久的效果，这被视为一种剂量效应。
