Supplementary file 1_Psychodynamic treatments taking an embodied perspective and their effect on depressive symptomatology: a systematic review and meta-analysis of randomized controlled trials.docx

IntroductionWithin a psychodynamic framework multiple theoretical models are offered in the treatment of depression and some of these models also integrate the subjective experience of the body. We give a brief overview of the subjective body in psychodynamic psychotherapies and the evidence regarding the efficacy of psychodynamic treatments addressing the subjective bodily experience in depression. The subsequent review then aimed at identifying the interventions applied within psychodynamic treatments taking an embodied perspective in the treatment of depression while also aggregating findings on their average efficacy.
MethodsA systematic review was carried out on RCTs comparing psychodynamic psychotherapy (PDP) addressing the subjective body to control conditions or bona fide therapies, the latter are therapies that have shown their efficacy in a broad context already. Outcomes were analyzed quantitatively using random effects models. The main characteristics of the applied treatment models were summarized narratively from the underlying intervention descriptions. Findings on the treatment models were structured in clusters according to their theoretical embedding.
ResultsEleven Trials matched the inclusion criteria with a total of 1,624 patients. Post treatment PDP addressing the subjective body differed from control conditions with a standardized mean difference (SMD) = −0.53 [p = 0.017, 95% CI (−0.97, −0.09), I2 = 89.12%]. At follow-up differences to control conditions remained to be present with SMD = −1.23 [p = 0.005, 95% CI (−2.10, −0.35), I2 = 90.35%]. Compared to bona fide therapies no differences were detected post-treatment when applying two-one-sided-tests [SMD = 0.08, p = 0.039, 90% CI (−0.064, 0.23)]. Throughout the applied interventions three overarching technical principles were identified. Concurrently marked differences existed.
ConclusionThe findings of our study suggest that PDPs addressing the subjective body are potentially efficacious. However, further conceptual elaboration on embodied treatment techniques is necessary. Subsequent studies should, in addition, scrutinize the contribution that these specific interventions make at the process and outcome level.
Systematic review registrationPROSPERO, identifier (CRD42024523337).

引言：在精神动力学框架下，抑郁治疗存在多种理论模型，其中部分模型同时整合了躯体的主观体验。本研究首先简要阐述精神动力学心理治疗中的躯体主观体验，以及针对抑郁患者、聚焦躯体主观体验的精神动力学治疗的有效性相关证据。后续的系统综述旨在识别抑郁治疗中采用具身取向的精神动力学治疗所应用的干预措施，同时汇总其平均有效性的相关研究结果。

方法：本研究针对聚焦躯体主观体验的精神动力学心理治疗（psychodynamic psychotherapy, PDP）与对照干预或确证有效治疗（bona fide therapies）的随机对照试验（randomized controlled trials, RCTs）开展了一项系统综述，其中确证有效治疗指已在广泛临床场景中被证实有效的治疗手段。研究采用随机效应模型对结局指标进行定量分析；从原始干预方案描述中，对所纳入治疗模型的核心特征进行叙述性总结，并依据其理论根基将治疗模型的相关研究发现划分为不同类别集群。

结果：共有11项符合纳入标准的随机对照试验，涉及受试者共计1624例。治疗后，聚焦躯体主观体验的PDP与对照组的标准化均数差（standardized mean difference, SMD）为−0.53 [p=0.017，95%置信区间（confidence interval, CI）为(−0.97, −0.09)，I²=89.12%]。随访阶段，两组间差异仍具有统计学意义，SMD=−1.23 [p=0.005，95%CI(−2.10, −0.35)，I²=90.35%]。与确证有效治疗相比，采用双向单侧检验分析后，治疗后两组未检出显著差异[SMD=0.08，p=0.039，90%CI(−0.064, 0.23)]。在纳入的干预方案中，共识别出3项核心技术原则，同时各原则间存在显著差异。

结论：本研究结果表明，聚焦躯体主观体验的PDP具有潜在的治疗有效性。但目前仍需进一步对具身治疗技术开展理论阐释与细化；后续研究还应深入剖析这类特异性干预在治疗过程与结局层面的作用贡献。

系统综述注册信息：PROSPERO，注册号（CRD42024523337）