The efficacy of psychodynamic therapy for social anxiety disorder–A comprehensive meta-analysis

•The efficacy of PDT is weaker than active groups and stronger than inactive groups.•Individual PDT and group PDT have significant different effects on SAD.•From multiple perspectives, it suggests that PDT can be used as an alternative treatment to the first-line psychotherapy CBT in the treatment of SAD.•Accompany symptom of SAD (depression) can be alleviated. The efficacy of psychodynamic therapy (PDT) on social anxiety disorder (SAD) is controversial among different randomized controlled trials (RCTs), so we decide to conduct a comprehensive meta-analysis to study the efficacy of PDT on SAD. Relevant literatures were searched in PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, PsycINFO, Clinical Trails, and Ovid Medline. Twelve RCTs including 1,213 patients were identified. The primary analysis showed that the efficacy of PDT was weaker than the active group (SMD = 0.15 [0.02, 0.28]) and stronger than the inactive group (SMD = -0.77 [-0.95, -0.58]). It suggested that there was significant difference between individual PDT and group PDT (Chi² = 2.84, P = 0.09), and no difference between PDT and CBT on SAD and in the dropout rate. Secondary analysis suggested that depression may be alleviated concurrently (SMD = -0.20 [-0.40, 0.00]). Meta-regression analysis revealed no linear associations between dropout rate and effect size (t = 0.79, P = 0.449), neither does the dose-response relationship between session and effect size (t = -0.01, P = 0.992). These findings demonstrated that PDT could produce significant SAD symptoms reduction and supported its application in treating SAD.