Efficacy of Psychodynamic Psychotherapy in Serious Physical Illness: Systematic Review and Meta‐Analysis

Objective Prevalence rates of depression and anxiety in patients with a serious physical illness are high. Psychodynamic psychotherapies show potential in mitigating such psychological distress because they address hindering relational experiences and unconscious conflicts that may impair patients’ capacity to cope with illness‐related distress. We investigated the efficacy of psychodynamic psychotherapy for symptoms of depression and anxiety in patients with serious physical illness. Methods We conducted a systematic literature search to identify randomized controlled trials and quasi‐experiments of psychodynamic psychotherapies in adults with serious physical illness. We conducted random‐effects meta‐analyses and narrative summaries. Results We identified 15,112 records and included 5 RCTs ( n = 648, mean age: 52.4 years, 69% female). Meta‐analyses showed no significant differences between psychodynamic and standard treatment for the reduction of depressive symptoms in serious physical illness (SMD = −0.24, 95% CI: −0.87 to 0.39). No meta‐analysis was calculated for anxiety symptoms due to the small number of studies investigating this outcome. Conclusion Quantitative evidence for the efficacy of psychodynamic psychotherapy in this population is inconclusive. More research is needed with regard to effective intervention length and adequate outcome measures, especially in patients with incurable illness.