The DPhase-study: Comparing short-term psychodynamic psychotherapy and cognitive behavioural therapy for major depressive disorder in a randomised controlled non-inferiority trial
Given both the large volume and manifold preferences of patients with depression, the availability of various effective treatments is important. Psychodynamic psychotherapy (PDT) has received less research in comparison to cognitive behavioural therapy (CBT) for major depressive disorder (MDD). This...
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| Veröffentlicht in: | Journal of affective disorders 2025-02, Vol.371, p.344-351 |
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| container_title | Journal of affective disorders |
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| creator | Miggiels, Maartje ten Klooster, Peter Beekman, Aartjan Bremer, Susanne Dekker, Jack Janssen, Colin van Dijk, Maarten K. |
| description | Given both the large volume and manifold preferences of patients with depression, the availability of various effective treatments is important. Psychodynamic psychotherapy (PDT) has received less research in comparison to cognitive behavioural therapy (CBT) for major depressive disorder (MDD). This study aimed to establish whether short-term psychodynamic supportive psychotherapy (SPSP) is non-inferior to CBT in the treatment of MDD.
A non-inferiority trial was conducted in a Dutch mental health setting, with 290 patients randomised to receive 16 sessions of either CBT or SPSP, over eight weeks. Primary outcome was depressive symptom severity assessed using the self-rated Inventory of Depressive Symptomatology (IDS-SR). The non-inferiority margin was prespecified as a − 5 post-treatment difference on the IDS-SR. Secondary outcome measures were functional impairment caused by symptoms assessed using the Sheehan disability scale (SDS), and wellbeing measured by the Mental Health Continuum-Short Form (MHC-SF).
Both intention-to-treat (baseline-adjusted mean difference 1.62, 95 % CI -1.82 to 5.05) and per-protocol analyses (mean difference 2.54; 95 % CI -0.63 to 5.72) showed SPSP to be non-inferior to CBT in reducing depressive symptoms. SPSP showed slightly but significantly higher remission rates and wellbeing scores.
Patients opting for other therapies or medication did not take part in the trial. Follow-up measures or clinician-rated questionnaires were not included.
The findings support SPSP as a viable treatment option for MDD, expanding the available choices for patients and broadening treatment options.
•Short-term psychodynamic supportive psychotherapy for depression is non-inferior to Cognitive behavioural therapy.•Short-term psychodynamic supportive psychotherapy is a viable alternative for treating MDD.•This study narrows the evidence gap between CBT and PDT. |
| doi_str_mv | 10.1016/j.jad.2024.10.122 |
| format | Article |
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A non-inferiority trial was conducted in a Dutch mental health setting, with 290 patients randomised to receive 16 sessions of either CBT or SPSP, over eight weeks. Primary outcome was depressive symptom severity assessed using the self-rated Inventory of Depressive Symptomatology (IDS-SR). The non-inferiority margin was prespecified as a − 5 post-treatment difference on the IDS-SR. Secondary outcome measures were functional impairment caused by symptoms assessed using the Sheehan disability scale (SDS), and wellbeing measured by the Mental Health Continuum-Short Form (MHC-SF).
Both intention-to-treat (baseline-adjusted mean difference 1.62, 95 % CI -1.82 to 5.05) and per-protocol analyses (mean difference 2.54; 95 % CI -0.63 to 5.72) showed SPSP to be non-inferior to CBT in reducing depressive symptoms. SPSP showed slightly but significantly higher remission rates and wellbeing scores.
Patients opting for other therapies or medication did not take part in the trial. Follow-up measures or clinician-rated questionnaires were not included.
The findings support SPSP as a viable treatment option for MDD, expanding the available choices for patients and broadening treatment options.
•Short-term psychodynamic supportive psychotherapy for depression is non-inferior to Cognitive behavioural therapy.•Short-term psychodynamic supportive psychotherapy is a viable alternative for treating MDD.•This study narrows the evidence gap between CBT and PDT.</description><identifier>ISSN: 0165-0327</identifier><identifier>ISSN: 1573-2517</identifier><identifier>EISSN: 1573-2517</identifier><identifier>DOI: 10.1016/j.jad.2024.10.122</identifier><identifier>PMID: 39486646</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Cognitive Behavioral Therapy - methods ; Cognitive behavioural therapy ; Depression ; Depressive Disorder, Major - therapy ; Female ; Humans ; Male ; Middle Aged ; Netherlands ; Psychiatric Status Rating Scales ; Psychodynamic psychotherapy ; Psychotherapy, Brief - methods ; Psychotherapy, Psychodynamic - methods ; Randomised controlled trial ; Treatment Outcome</subject><ispartof>Journal of affective disorders, 2025-02, Vol.371, p.344-351</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c235t-f22333f3681328ce3a38278c02ac3086e06c793723ee8ae2cac07432743ee6e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jad.2024.10.122$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39486646$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miggiels, Maartje</creatorcontrib><creatorcontrib>ten Klooster, Peter</creatorcontrib><creatorcontrib>Beekman, Aartjan</creatorcontrib><creatorcontrib>Bremer, Susanne</creatorcontrib><creatorcontrib>Dekker, Jack</creatorcontrib><creatorcontrib>Janssen, Colin</creatorcontrib><creatorcontrib>van Dijk, Maarten K.</creatorcontrib><title>The DPhase-study: Comparing short-term psychodynamic psychotherapy and cognitive behavioural therapy for major depressive disorder in a randomised controlled non-inferiority trial</title><title>Journal of affective disorders</title><addtitle>J Affect Disord</addtitle><description>Given both the large volume and manifold preferences of patients with depression, the availability of various effective treatments is important. Psychodynamic psychotherapy (PDT) has received less research in comparison to cognitive behavioural therapy (CBT) for major depressive disorder (MDD). This study aimed to establish whether short-term psychodynamic supportive psychotherapy (SPSP) is non-inferior to CBT in the treatment of MDD.
A non-inferiority trial was conducted in a Dutch mental health setting, with 290 patients randomised to receive 16 sessions of either CBT or SPSP, over eight weeks. Primary outcome was depressive symptom severity assessed using the self-rated Inventory of Depressive Symptomatology (IDS-SR). The non-inferiority margin was prespecified as a − 5 post-treatment difference on the IDS-SR. Secondary outcome measures were functional impairment caused by symptoms assessed using the Sheehan disability scale (SDS), and wellbeing measured by the Mental Health Continuum-Short Form (MHC-SF).
Both intention-to-treat (baseline-adjusted mean difference 1.62, 95 % CI -1.82 to 5.05) and per-protocol analyses (mean difference 2.54; 95 % CI -0.63 to 5.72) showed SPSP to be non-inferior to CBT in reducing depressive symptoms. SPSP showed slightly but significantly higher remission rates and wellbeing scores.
Patients opting for other therapies or medication did not take part in the trial. Follow-up measures or clinician-rated questionnaires were not included.
The findings support SPSP as a viable treatment option for MDD, expanding the available choices for patients and broadening treatment options.
•Short-term psychodynamic supportive psychotherapy for depression is non-inferior to Cognitive behavioural therapy.•Short-term psychodynamic supportive psychotherapy is a viable alternative for treating MDD.•This study narrows the evidence gap between CBT and PDT.</description><subject>Adult</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Cognitive behavioural therapy</subject><subject>Depression</subject><subject>Depressive Disorder, Major - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Netherlands</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychodynamic psychotherapy</subject><subject>Psychotherapy, Brief - methods</subject><subject>Psychotherapy, Psychodynamic - methods</subject><subject>Randomised controlled trial</subject><subject>Treatment Outcome</subject><issn>0165-0327</issn><issn>1573-2517</issn><issn>1573-2517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUGP1CAUx4nRuLOjH8CL4eilI4WWdvRkRl1NNtHDeiYsvG6ZtFAfdJJ-rv2CUmfWoxce_PPjz3v8CXlTsl3JSvn-uDtqu-OMV7tV4vwZ2ZR1Iwpel81zsslMXTDBmytyHeORMSb3DXtJrsS-aqWs5IY83vVAP__sdYQiptkuH-ghjJNG5x9o7AOmIgGOdIqL6YNdvB6duZxSD6inhWpvqQkP3iV3AnoPvT65MKMe6BPRBaSjPubVwoQQ4wpaFwNaQOo81RSzSxhdhNXLJwzDkLc--ML5DtAFdGmhCZ0eXpEXnR4ivL7ULfn19cvd4Vtx--Pm--HTbWG4qFPRcS6E6IRsS8FbA0KLljetYVwbwVoJTJpmLxouAFoN3GjDmir_VpUFCUJsybuz74Th9wwxqdyfgWHQHsIclSjzOzUTssloeUYNhhgROjWhGzUuqmRqzUodVc5KrVn9lXJvW_L2Yj_fj2D_3XgKJwMfzwDkIU8OUEXjwBuwDsEkZYP7j_0fXzypSg</recordid><startdate>20250215</startdate><enddate>20250215</enddate><creator>Miggiels, Maartje</creator><creator>ten Klooster, Peter</creator><creator>Beekman, Aartjan</creator><creator>Bremer, Susanne</creator><creator>Dekker, Jack</creator><creator>Janssen, Colin</creator><creator>van Dijk, Maarten K.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20250215</creationdate><title>The DPhase-study: Comparing short-term psychodynamic psychotherapy and cognitive behavioural therapy for major depressive disorder in a randomised controlled non-inferiority trial</title><author>Miggiels, Maartje ; ten Klooster, Peter ; Beekman, Aartjan ; Bremer, Susanne ; Dekker, Jack ; Janssen, Colin ; van Dijk, Maarten K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c235t-f22333f3681328ce3a38278c02ac3086e06c793723ee8ae2cac07432743ee6e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adult</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>Cognitive behavioural therapy</topic><topic>Depression</topic><topic>Depressive Disorder, Major - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychodynamic psychotherapy</topic><topic>Psychotherapy, Brief - methods</topic><topic>Psychotherapy, Psychodynamic - methods</topic><topic>Randomised controlled trial</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miggiels, Maartje</creatorcontrib><creatorcontrib>ten Klooster, Peter</creatorcontrib><creatorcontrib>Beekman, Aartjan</creatorcontrib><creatorcontrib>Bremer, Susanne</creatorcontrib><creatorcontrib>Dekker, Jack</creatorcontrib><creatorcontrib>Janssen, Colin</creatorcontrib><creatorcontrib>van Dijk, Maarten K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of affective disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miggiels, Maartje</au><au>ten Klooster, Peter</au><au>Beekman, Aartjan</au><au>Bremer, Susanne</au><au>Dekker, Jack</au><au>Janssen, Colin</au><au>van Dijk, Maarten K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The DPhase-study: Comparing short-term psychodynamic psychotherapy and cognitive behavioural therapy for major depressive disorder in a randomised controlled non-inferiority trial</atitle><jtitle>Journal of affective disorders</jtitle><addtitle>J Affect Disord</addtitle><date>2025-02-15</date><risdate>2025</risdate><volume>371</volume><spage>344</spage><epage>351</epage><pages>344-351</pages><issn>0165-0327</issn><issn>1573-2517</issn><eissn>1573-2517</eissn><abstract>Given both the large volume and manifold preferences of patients with depression, the availability of various effective treatments is important. Psychodynamic psychotherapy (PDT) has received less research in comparison to cognitive behavioural therapy (CBT) for major depressive disorder (MDD). This study aimed to establish whether short-term psychodynamic supportive psychotherapy (SPSP) is non-inferior to CBT in the treatment of MDD.
A non-inferiority trial was conducted in a Dutch mental health setting, with 290 patients randomised to receive 16 sessions of either CBT or SPSP, over eight weeks. Primary outcome was depressive symptom severity assessed using the self-rated Inventory of Depressive Symptomatology (IDS-SR). The non-inferiority margin was prespecified as a − 5 post-treatment difference on the IDS-SR. Secondary outcome measures were functional impairment caused by symptoms assessed using the Sheehan disability scale (SDS), and wellbeing measured by the Mental Health Continuum-Short Form (MHC-SF).
Both intention-to-treat (baseline-adjusted mean difference 1.62, 95 % CI -1.82 to 5.05) and per-protocol analyses (mean difference 2.54; 95 % CI -0.63 to 5.72) showed SPSP to be non-inferior to CBT in reducing depressive symptoms. SPSP showed slightly but significantly higher remission rates and wellbeing scores.
Patients opting for other therapies or medication did not take part in the trial. Follow-up measures or clinician-rated questionnaires were not included.
The findings support SPSP as a viable treatment option for MDD, expanding the available choices for patients and broadening treatment options.
•Short-term psychodynamic supportive psychotherapy for depression is non-inferior to Cognitive behavioural therapy.•Short-term psychodynamic supportive psychotherapy is a viable alternative for treating MDD.•This study narrows the evidence gap between CBT and PDT.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>39486646</pmid><doi>10.1016/j.jad.2024.10.122</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of affective disorders, 2025-02, Vol.371, p.344-351 |
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| subjects | Adult Cognitive Behavioral Therapy - methods Cognitive behavioural therapy Depression Depressive Disorder, Major - therapy Female Humans Male Middle Aged Netherlands Psychiatric Status Rating Scales Psychodynamic psychotherapy Psychotherapy, Brief - methods Psychotherapy, Psychodynamic - methods Randomised controlled trial Treatment Outcome |
| title | The DPhase-study: Comparing short-term psychodynamic psychotherapy and cognitive behavioural therapy for major depressive disorder in a randomised controlled non-inferiority trial |
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