Methods/Principal Findings
Cochrane systematic review methodology with meta-analysis and trial sequential analysis of
randomized trials comparing the effect of psychodynamic therapies versus ‘treatment as usual’for
major depressive disorder. To be included the participants had to be older than 17 years with a primary
diagnosis of major depressive disorder. Altogether, we included six trials randomizing a total of 648
participants. Five trials assessed ‘interpersonal psychotherapy’ and only one trial
assessed ‘psychodynamic psychotherapy’. All six trials had high risk of bias. Meta-analysis on all six
trials showed that the psychodynamic interventions significantly reduced depressive symptoms on the
17-item Hamilton Rating Scale for Depression (mean difference -3.12 (95% confidence interval-4.39
to -1.86;P<0.00001), no heterogeneity) compared with 'treatment as usual'. Trial sequential analysis
confirmed this result.