Pharmacotherapy, cognitive-behavioral therapy (CBT), and psychodynamic therapy are most frequently applied to treat mental disorders. However, whether psychodynamic therapy is as efficacious as other empirically supported treatments is not yet clear. Thus, for the first time the equivalence of psychodynamic therapy to treatments established in efficacy was formally tested. The authors controlled for researcher allegiance effects by including representatives of psychodynamic therapy and CBT, the main rival psychotherapeutic treatments (adversarial collaboration).

The authors applied the formal criteria for testing equivalence, implying a particularly strict test: a priori defining a margin compatible with equivalence (g=0.25), using the two one-sided test procedure, and ensuring the efficacy of the comparator. Independent raters assessed effect sizes, study quality, and allegiance. A systematic literature search used the following criteria: randomized controlled trial of manual-guided psychodynamic therapy in adults, testing psychodynamic therapy against a treatment with efficacy established for the disorder under study, and applying reliable and valid outcome measures. The primary outcome was “target symptoms” (e.g., depressive symptoms in depressive disorders).

Twenty-three randomized controlled trials with 2,751 patients were included. The mean study quality was good as demonstrated by reliable rating methods. Statistical analyses showed equivalence of psychodynamic therapy to comparison conditions for target symptoms at posttreatment (g=−0.153, 90% equivalence CI=−0.227 to −0.079) and at follow-up (g=−0.049, 90% equivalence CI=−0.137 to −0.038) because both CIs were included in the equivalence interval (−0.25 to 0.25).

Results suggest equivalence of psychodynamic therapy to treatments established in efficacy. Further research should examine who benefits most from which treatment.

药物疗法，认知行为疗法（CBT）和心理动力疗法最常用于治疗精神障碍。但是，目前尚不清楚心理动力疗法是否与其他经验支持疗法一样有效。因此，首次正式测试了心理动力疗法与以疗效确立的治疗方法的等效性。作者通过包括心理动力疗法和CBT（主要竞争对手心理疗法）（对抗合作）的代表来控制研究人员的效忠效应。

作者应用了用于测试等效性的正式标准，这意味着要进行特别严格的测试：使用两个单面测试程序来先验定义与等效性兼容的裕度（g = 0.25），并确保比较器的有效性。独立评估者评估效应量，研究质量和忠诚度。一项系统的文献检索使用以下标准：成人人工指导的心理动力疗法的随机对照试验，针对已针对所研究的疾病确定疗效的心理动力疗法进行测试，并采用可靠有效的结局指标。主要结果是“目标症状”（例如，抑郁症中的抑郁症状）。

纳入了2 751例患者的23项随机对照试验。可靠的评分方法表明，平均研究质量良好。统计分析表明，在治疗后（g = -0.153，90％等效项CI = -0.227至-0.079）和随访时（g = -0.049，90％等效项CI = -0.137），心理动力疗法与比较目标症状的比较条件等效到-0.038），因为两个配置项都包括在等效区间内（-0.25到0.25）。

结果表明，心理动力疗法等同于疗效确定的疗法。进一步的研究应检查谁从哪种治疗中受益最大。