Randi Ulberg1,2,3, Benjamin Hummelen4, Anne Grete Hersoug5, Nick Midgley6, Per Andreas Høglend5, Hanne-Sofie Johnsen Dahl5,7. 1. Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, P.O. box 1171, 0318, Blindern, Oslo, Norway. randi.ulberg@medisin.uio.no. 2. Vestfold Hospital Trust, Division of Mental Health, Research Unit, P.O. box 2169, 3125, Tønsberg, Norway. randi.ulberg@medisin.uio.no. 3. Department of Psychiatry, Diakonhjemmet Hospital, Box 85 Vinderen 0319, Oslo, Norway. randi.ulberg@medisin.uio.no. 4. Division of Mental Health and Addiction, Oslo University Hospital, P.O. box 4959, N-0424, Nydalen, Oslo, Norway. 5. Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, P.O. box 1171, 0318, Blindern, Oslo, Norway. 6. University College London (UCL) and Anna Freud National Centre for Children and Families, London, UK. 7. Department of Psychology, Faculty of Social Sciences, University of Oslo, Postboks 1094 Blindern, 0317, Oslo, Norway.
Abstract
BACKGROUND: Little is known about the influence on outcome of exploration of the patient-therapist relationship (that is, transference work) in psychoanalytic psychotherapy. We hypothesized that depressed adolescents would have better long-term effects from psychoanalytic psychotherapy with than without transference work. METHODS:Depressed adolescent (16 to 18 years) were recruited in health authority funded out-patient clinics in Oslo and Vestfold County, Norway. They were randomized to 28 weeks of treatment with psychoanalytic psychotherapy with or without transference work. Change was assessed using linear-mixed models. The primary outcome measure was the Psychodynamic Functioning Scale (pre- post-, and 1-year post-treatment). Level of depression was measured at the same time points and during therapy (week 12, and 20). RESULTS:69 adolescents were treated with (N = 39) or without (N = 31) transference work. The mean number of sessions was 18.6 (SD = 8,6) in the transference work group and 18.0 (SD = 10.9) in the non-transference work group. Both groups showed large and significant improvement on Psychodynamic Functioning Scale during the whole study period. The difference between the two groups was not significant during the treatment period (95% CI -.79 to 1.2, p = .674, F = .18), or from post-treatment to one-year follow-up (95% CI -.13 to .96; p = .134; F = 2.3). For the secondary outcome measures the transference work group had significantly better outcomes from 12 weeks in treatment to one-year follow-up (Beck Depression Inventory, 95% CI - 1.7 to -.14, p = .022; Montgomery and Åsberg Depression Rating Scale, 95% CI - 1.6 to -.23, p = .009). CONCLUSION: The findings suggest that exploration of the adolescents' relations to the therapist amplify the effects of short-term psychoanalytic psychotherapy on their depressive symptoms for adolescents with a Major Depressive Disorder. TRIAL REGISTRATION: ClinicalTrials.gov . Id: NCT01531101 . Registered 8 February 2012.
RCT Entities:
BACKGROUND: Little is known about the influence on outcome of exploration of the patient-therapist relationship (that is, transference work) in psychoanalytic psychotherapy. We hypothesized that depressed adolescents would have better long-term effects from psychoanalytic psychotherapy with than without transference work. METHODS: Depressed adolescent (16 to 18 years) were recruited in health authority funded out-patient clinics in Oslo and Vestfold County, Norway. They were randomized to 28 weeks of treatment with psychoanalytic psychotherapy with or without transference work. Change was assessed using linear-mixed models. The primary outcome measure was the Psychodynamic Functioning Scale (pre- post-, and 1-year post-treatment). Level of depression was measured at the same time points and during therapy (week 12, and 20). RESULTS: 69 adolescents were treated with (N = 39) or without (N = 31) transference work. The mean number of sessions was 18.6 (SD = 8,6) in the transference work group and 18.0 (SD = 10.9) in the non-transference work group. Both groups showed large and significant improvement on Psychodynamic Functioning Scale during the whole study period. The difference between the two groups was not significant during the treatment period (95% CI -.79 to 1.2, p = .674, F = .18), or from post-treatment to one-year follow-up (95% CI -.13 to .96; p = .134; F = 2.3). For the secondary outcome measures the transference work group had significantly better outcomes from 12 weeks in treatment to one-year follow-up (Beck Depression Inventory, 95% CI - 1.7 to -.14, p = .022; Montgomery and Åsberg Depression Rating Scale, 95% CI - 1.6 to -.23, p = .009). CONCLUSION: The findings suggest that exploration of the adolescents' relations to the therapist amplify the effects of short-term psychoanalytic psychotherapy on their depressive symptoms for adolescents with a Major Depressive Disorder. TRIAL REGISTRATION: ClinicalTrials.gov . Id: NCT01531101 . Registered 8 February 2012.
Entities:
Keywords:
Major Depressive Disorder; Psychoanalytic; Psychodynamic; Transference; Youth psychotherapy
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