精神动力学和分析心理疗法在日常护理中的长期疗效
精神动力学和分析心理疗法在日常护理中的长期疗效：一项为期6年的自然观察研究结果
The long-term effectiveness of psychodynamic and analytical psychotherapy in routine care: Results from a naturalistic study over 6 years
——《咨询与临床心理学杂志》第93卷第12期，2025年12月——
【摘要】目的：本自然观察研究旨在考察两种以精神分析为导向的疗法——精神动力学心理疗法（PP）和分析心理疗法（AP）——在德国常规医疗机构中的长期疗效。方法：共有428名根据《精神疾病诊断与统计手册》（第四版）诊断为各种精神障碍的患者接受了PP或AP治疗。治疗结束后重新评估了诊断结果，并在6年期间每年收集患者的心理健康自评报告。我们采用倾向评分法和分段线性潜在增长曲线模型来评估治疗对主要结局指标（即诊断数量、症状困扰程度）和次要结局指标（即人格功能障碍、人际关系问题、总体生活满意度）的影响。结果：两种疗法均使患者在所有结局指标上表现出显著且持续的改善。值得注意的是，与PP组相比，AP组患者在主要结局指标和大多数次要结局指标上获得了更大的（长期）改善。 PP组的改善主要发生在第一年，而AP组患者在整个观察期内持续取得进步。对于某些结局指标（症状困扰、人格功能障碍和人际关系问题），AP组对基线时问题更严重的患者尤其有效。结论：在常规护理中采用精神分析取向的治疗可带来显著且持久的改善，即使在治疗结束后也是如此。我们的研究结果强调了AP组相对于PP组的额外优势，尤其是在复杂病例中。未来的研究应探索治疗机制、成本效益以及对卫生政策的影响。
【关键词】精神分析取向的心理治疗；自然观察研究；长期心理治疗；长期疗效；常规护理
[Abstract] Objective: This naturalistic study examines the long-term effectiveness of two psychoanalytically oriented therapies—psychodynamic psychotherapy (PP) and analytical psychotherapy (AP)—in routine care settings in Germany. Method: A total of 428 patients diagnosed with various mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, underwent treatment with either PP or AP. Diagnoses were reassessed at the end of treatment, and patients provided annual self-reports of their mental health over a 6-year period. We employed propensity score methods and piecewise linear latent growth curve models to estimate treatment effects on primary outcomes (i.e., number of diagnoses, symptom distress) and secondary outcomes (i.e., personality dysfunction, interpersonal problems, general life satisfaction). Results: Patients exhibited substantial and sustained improvements across all outcomes in both treatments. Notably, those receiving AP experienced greater (long-term) improvement in primary and most secondary outcomes compared to those in PP. Improvements in PP primarily occurred during the 1st year, while AP patients continued to show progress throughout the entire observation period. For some outcomes (symptom distress, personality dysfunction, and interpersonal problems), AP was particularly effective for patients with more severe problems at baseline. Conclusions: Psychoanalytically oriented treatments in routine care are associated with substantial and lasting improvements, even posttreatment. Our findings highlight an incremental benefit of AP over PP, particularly for complex cases. Future research should explore treatment mechanisms, cost-effectiveness, and implications for health policy.
[Key words] psychoanalytically oriented psychotherapy; naturalistic study; long-term psychotherapy; long-term effectiveness; routine care
论文原文：Miriam Henkel, Johannes Zimmermann, Matthias Volz, Dorothea Huber, Hermann Staats, Cord Benecke (2025). The long-term effectiveness of psychodynamic and analytical psychotherapy in routine care: Results from a naturalistic study over 6 years. Journal of Consulting and Clinical Psychology, Volume 93, Issue 12, Pages 814–828. December 2025.
https://doi.org/10.1037/ccp0000985
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