Supplementary Material for: The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

<b><i>Background:</i></b> The Task Force on Promotion and Dissemination of Psychological Procedures proposed rigorous criteria to define empirically supported psychotherapies. According to these criteria, 2 randomized controlled trials (RCTs) showing efficacy are required for a treatment to be designated as ‘efficacious' and 1 RCT for a designation as ‘possibly efficacious'. Applying these criteria modified by Chambless and Hollon, this article presents an update on the evidence for psychodynamic therapy (PDT) in specific mental disorders. <b><i>Methods:</i></b> A systematic search was performed using the criteria by Chambless and Hollon for study selection, as follows: (1) RCT of PDT in adults, (2) use of reliable and valid measures for diagnosis and outcome, (3) use of treatment manuals or manual-like guidelines, (4) adult population treated for specific problems and (5) PDT superior to no treatment, placebo or alternative treatment or equivalent to an established treatment. <b><i>Results:</i></b> A total of 39 RCTs were included. Following Chambless and Hollon, PDT can presently be designated as efficacious in major depressive disorder (MDD), social anxiety disorder, borderline and heterogeneous personality disorders, somatoform pain disorder, and anorexia nervosa. For MDD, this also applies to the combination with pharmacotherapy. PDT can be considered as possibly efficacious in dysthymia, complicated grief, panic disorder, generalized anxiety disorder, and substance abuse/dependence. Evidence is lacking for obsessive-compulsive, posttraumatic stress, bipolar and schizophrenia spectrum disorder(s). <b><i>Conclusions:</i></b> Evidence has emerged that PDT is efficacious or possibly efficacious in a wide range of common mental disorders. Further research is required for those disorders for which sufficient evidence does not yet exist.

<b><i>背景：</i></b> 心理疗法推广与传播专项工作组（Task Force on Promotion and Dissemination of Psychological Procedures）提出了严格的标准，用以界定经实证支持的心理疗法。根据该标准，若要将某疗法认定为"有效疗法"，需开展2项显示其疗效的随机对照试验（randomized controlled trial, RCT）；若认定为"可能有效疗法"，则仅需1项随机对照试验。本文采用由钱布利斯（Chambless）与霍洛恩（Hollon）修订后的上述标准，对针对特定精神障碍的心理动力学疗法（psychodynamic therapy, PDT）的相关研究证据进行了更新梳理。<b><i>方法：</i></b> 本次研究采用钱布利斯（Chambless）与霍洛恩提出的标准开展系统性文献检索，文献筛选标准如下：(1) 针对成人群体的心理动力学疗法随机对照试验；(2) 采用信效度良好的工具进行诊断与疗效评估；(3) 研究使用标准化治疗手册或类手册式指导方案；(4) 研究对象为存在特定心理问题的成人群体；(5) 心理动力学疗法的疗效优于无治疗组、安慰剂组或其他替代疗法，或与已证实有效的疗法疗效相当。<b><i>结果：</i></b> 最终共纳入39项随机对照试验。依据钱布利斯与霍洛恩的标准，当前可将心理动力学疗法认定为对重性抑郁障碍（major depressive disorder, MDD）、社交焦虑障碍、边缘型与异质性人格障碍、躯体形式疼痛障碍以及神经性厌食症具有疗效。针对重性抑郁障碍，联合药物治疗的情况亦符合该认定标准。心理动力学疗法可被认定为可能有效的病症包括心境恶劣障碍、复杂性哀伤障碍、惊恐障碍、广泛性焦虑障碍以及物质滥用/依赖。但针对强迫障碍、创伤后应激障碍、双相障碍及精神分裂症谱系障碍，目前尚无足够的相关研究证据。<b><i>结论：</i></b> 现有研究证据表明，心理动力学疗法在多种常见精神障碍中均展现出疗效或潜在疗效。针对目前尚无足够研究证据的精神障碍类型，仍需开展进一步的相关研究。