The Long-Term Effectiveness of Psychodynamic and Analytical Psychotherapy in Routine Care: Results from a Pragmatic Study over Six Years

Objective: This pragmatic 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 DSM-IV mental disorders 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 six-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 DSM-IV diagnoses, symptom distress) and secondary outcomes (e.g., 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 several secondary outcomes compared to those in PP. Improvements in PP primarily occurred during the first 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 post-treatment. 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.