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The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis
BACKGROUND: The optimal psychotherapy duration for mental health disorders is unclear. Our aim was to assess the beneficial and harmful effects of shorter- versus longer-term psychotherapy for adult mental health disorders. METHOD: We searched relevant databases and websites for published and unpubl...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273498/ https://www.ncbi.nlm.nih.gov/pubmed/37328755 http://dx.doi.org/10.1186/s12888-023-04895-6 |
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author | Juul, Sophie Jakobsen, Janus Christian Jørgensen, Caroline Kamp Poulsen, Stig Sørensen, Per Simonsen, Sebastian |
author_facet | Juul, Sophie Jakobsen, Janus Christian Jørgensen, Caroline Kamp Poulsen, Stig Sørensen, Per Simonsen, Sebastian |
author_sort | Juul, Sophie |
collection | PubMed |
description | BACKGROUND: The optimal psychotherapy duration for mental health disorders is unclear. Our aim was to assess the beneficial and harmful effects of shorter- versus longer-term psychotherapy for adult mental health disorders. METHOD: We searched relevant databases and websites for published and unpublished randomised clinical trials assessing different durations of the same psychotherapy type before June 27, 2022. Our methodology was based on Cochrane and an eight-step procedure. Primary outcomes were quality of life, serious adverse events, and symptom severity. Secondary outcomes were suicide or suicide-attempts, self-harm, and level of functioning. RESULTS: We included 19 trials randomising 3,447 participants. All trials were at high risk of bias. Three single trials met the required information size needed to confirm or reject realistic intervention effects. One single trial showed no evidence of a difference between 6 versus 12 months dialectical behavioral therapy for borderline personality when assessing quality of life, symptom severity, and level of functioning. One single trial showed evidence of a beneficial effect of adding booster sessions to 8 and 12 weeks of internet-based cognitive behavioral therapy for depression and anxiety when assessing symptom severity and level of functioning. One single trial showed no evidence of a difference between 20 weeks versus 3 years of psychodynamic psychotherapy for mood- or anxiety disorders when assessing symptom severity and level of functioning. It was only possible to conduct two pre-planned meta-analyses. Meta-analysis showed no evidence of a difference between shorter- and longer-term cognitive behavioural therapy for anxiety disorders on anxiety symptoms at end of treatment (SMD: 0.08; 95% CI: -0.47 to 0.63; p = 0.77; I(2) = 73%; four trials; very low certainty). Meta-analysis showed no evidence of a difference between shorter and longer-term psychodynamic psychotherapy for mood- and anxiety disorders on level of functioning (SMD 0.16; 95% CI -0.08 to 0.40; p = 0.20; I(2) = 21%; two trials; very low certainty). CONCLUSIONS: The evidence for shorter versus longer-term psychotherapy for adult mental health disorders is currently unclear. We only identified 19 randomised clinical trials. More trials at low risk of bias and at low risk of random errors assessing participants at different levels of psychopathological severity are urgently needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019128535. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-023-04895-6. |
format | Online Article Text |
id | pubmed-10273498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102734982023-06-17 The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis Juul, Sophie Jakobsen, Janus Christian Jørgensen, Caroline Kamp Poulsen, Stig Sørensen, Per Simonsen, Sebastian BMC Psychiatry Research BACKGROUND: The optimal psychotherapy duration for mental health disorders is unclear. Our aim was to assess the beneficial and harmful effects of shorter- versus longer-term psychotherapy for adult mental health disorders. METHOD: We searched relevant databases and websites for published and unpublished randomised clinical trials assessing different durations of the same psychotherapy type before June 27, 2022. Our methodology was based on Cochrane and an eight-step procedure. Primary outcomes were quality of life, serious adverse events, and symptom severity. Secondary outcomes were suicide or suicide-attempts, self-harm, and level of functioning. RESULTS: We included 19 trials randomising 3,447 participants. All trials were at high risk of bias. Three single trials met the required information size needed to confirm or reject realistic intervention effects. One single trial showed no evidence of a difference between 6 versus 12 months dialectical behavioral therapy for borderline personality when assessing quality of life, symptom severity, and level of functioning. One single trial showed evidence of a beneficial effect of adding booster sessions to 8 and 12 weeks of internet-based cognitive behavioral therapy for depression and anxiety when assessing symptom severity and level of functioning. One single trial showed no evidence of a difference between 20 weeks versus 3 years of psychodynamic psychotherapy for mood- or anxiety disorders when assessing symptom severity and level of functioning. It was only possible to conduct two pre-planned meta-analyses. Meta-analysis showed no evidence of a difference between shorter- and longer-term cognitive behavioural therapy for anxiety disorders on anxiety symptoms at end of treatment (SMD: 0.08; 95% CI: -0.47 to 0.63; p = 0.77; I(2) = 73%; four trials; very low certainty). Meta-analysis showed no evidence of a difference between shorter and longer-term psychodynamic psychotherapy for mood- and anxiety disorders on level of functioning (SMD 0.16; 95% CI -0.08 to 0.40; p = 0.20; I(2) = 21%; two trials; very low certainty). CONCLUSIONS: The evidence for shorter versus longer-term psychotherapy for adult mental health disorders is currently unclear. We only identified 19 randomised clinical trials. More trials at low risk of bias and at low risk of random errors assessing participants at different levels of psychopathological severity are urgently needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019128535. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-023-04895-6. BioMed Central 2023-06-16 /pmc/articles/PMC10273498/ /pubmed/37328755 http://dx.doi.org/10.1186/s12888-023-04895-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Juul, Sophie Jakobsen, Janus Christian Jørgensen, Caroline Kamp Poulsen, Stig Sørensen, Per Simonsen, Sebastian The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis |
title | The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis |
title_full | The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis |
title_fullStr | The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis |
title_full_unstemmed | The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis |
title_short | The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis |
title_sort | difference between shorter- versus longer-term psychotherapy for adult mental health disorders: a systematic review with meta-analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273498/ https://www.ncbi.nlm.nih.gov/pubmed/37328755 http://dx.doi.org/10.1186/s12888-023-04895-6 |
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