Lindegaard Tomas, Berg Matilda, Andersson Gerhard
Clinical Psychology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
Clinical Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Psychodyn Psychiatry. 2020 Winter;48(4):437-454. doi: 10.1521/pdps.2020.48.4.437.
Recent years have seen an increase of internet-delivered interventions based on psychodynamic treatment models. To test the efficacy of internet-delivered psychodynamic therapy (IPDT), we conducted a systematic review and meta-analysis of randomized controlled trials. Following literature searches, we identified seven studies meeting inclusion criteria. The total number of participants was 528 in the treatment group and 552 in the control conditions. We found small effects favoring IPDT compared to inactive control conditions for main outcomes (g = 0.44), depression (g = 0.46), anxiety (g = 0.20), and quality of life (g = 0.40). There was significant heterogeneity between studies for main outcomes and depression. Within-group effects ranged from Hedges's g = 0.32-0.99. The effects of IPDT were maintained or increased at follow-up. Study quality varied but was generally high. No indications of publication bias were found. In conclusion, IPDT is a promising treatment alternative, especially for depression, although the small number of studies limits the generalizability of the findings.
近年来,基于心理动力学治疗模式的互联网干预有所增加。为了测试互联网心理动力学治疗(IPDT)的疗效,我们对随机对照试验进行了系统评价和荟萃分析。经过文献检索,我们确定了7项符合纳入标准的研究。治疗组的参与者总数为528人,对照组为552人。我们发现,与无活性对照条件相比,IPDT在主要结局(g = 0.44)、抑郁(g = 0.46)、焦虑(g = 0.20)和生活质量(g = 0.40)方面有较小的效果优势。主要结局和抑郁方面的研究之间存在显著异质性。组内效应范围为Hedges's g = 0.32 - 0.99。IPDT的效果在随访时保持或增强。研究质量各不相同,但总体较高。未发现发表偏倚的迹象。总之,IPDT是一种有前景的治疗选择,尤其是对于抑郁症,尽管研究数量较少限制了研究结果的普遍性。