How Effective is Psychodynamic Therapy for Depression?

By Charity Shumway

Psychodynamic therapy has been widely used for decades, but few studies have empirically examined its effectiveness. In 2001, Jacques P. Barber, Ph.D., who joined the Gordon F. Derner Institute of Advanced Psychological Studies as dean in August 2011, and colleagues at the University of Pennsylvania set out to conduct just such a study.

With funding from the National Institute of Mental Health, they recruited a sample of 156 patients suffering from major depressive disorder and randomly assigned each patient to one of three treatments for a 16-week period: psychodynamic therapy, antidepressant medication or a placebo.

What the researchers found surprised them. Dean Barber and his colleagues expected results indicating that treatment with either psychodynamic therapy or medication would be more effective than treatment with a placebo. Disappointingly, no real differences emerged among the treatments.

But further analysis of the data yielded more surprises. “We looked at the impact of gender and minority status, and we found a significant interaction,” Dean Barber said.

The study drew participants from urban Philadelphia, and, as a result, the sample population was 52 percent minority and 41 percent male, much higher percentages of minorities and males than in the average sample of patients in pharmacotherapy trials for depression.

When they looked at subgroups within the sample, Dean Barber and his colleagues found real differences emerged among outcomes. For minority men, psychodynamic therapy proved most effective. For white men, the placebo emerged as the most effective treatment. For minority women, no significant difference was found among the treatments.

White women were the only group for whom the study’s original hypothesis proved true. For that subgroup, medication and psychodynamic therapy both proved more effective than placebo treatment.

The study was published in The Journal of Clinical Psychiatry in December 2011, and Dean Barber is hopeful that the publication will lead to further research. “Our results were interesting, but with only 156 patients, when you speak about three groups of patients, you don’t have that many patients per treatment cell,” he said.

Additionally, there is the concern that the original goal of the study was not to examine minority and gender-related outcomes, and post hoc analysis means additional research is necessary to replicate the findings. With this in mind, Dean Barber is optimistic about future research in this area. “Hopefully, people will see the research and decide to study these kinds of questions,” he said.

This piece appeared in the Derner eNews Spring 2012 edition.