Depression Studies Pertinent to NICE Guidelines: Short-term Psychodynamic Psychotherapies (STPP)

Overview STPP methods have been developed and researched over the past 40 years to shorten emotionally focused treatment of a broad range of conditions including depression, anxiety, somatic problems and personality disorders. These treatments are under 40 sessions of average and have now been studied with over 60 randomized controlled trials of variable quality and 5 meta-analyses that support the method as being effective compared to minimal treatment and wait list controls for a broad range of conditions as noted above. (Abbass AA, Hancock JT, Henderson J, et al. Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews. 2006(4). Herein, I will provide references (and abstracts of more recent studies) to RCT and Non-RCT studies of STPP with depression. Because depression, and especially treatment resistant depression, is often mixed with personality disorder (PD), I will highlight the body of data showing the efficacy of this method in PD and some studies that examined the 2 conditions. This is critical to examine because we know that the majority of patients treated with front line treatment do not remit, thus treatment resistance of some degree is the norm. For any brief treatment to be effective and have a significant impact on the overall system, personality problems must thus be addressed. In summary, STPP is effective with lasting effects, likely cost effective, and preferred by patients over medication treatments. STPP is also effective with personality disorders even combined with depression suggesting they be considered a first line option in those cases to reduce the rate of non-response and perhaps prevent chronicity.