Psychodynamic treatments taking an embodied perspective and their effect on depressive symptomatology: a systematic review and meta-analysis of randomized controlled trials

Introduction Within a psychodynamic framework multiple theoretical models are offered in the treatment of depression and some of these models also integrate the subjective experience of the body. We give a brief overview of the subjective body in psychodynamic psychotherapies and the evidence regarding the efficacy of psychodynamic treatments addressing the subjective bodily experience in depression. The subsequent review then aimed at identifying the interventions applied within psychodynamic treatments taking an embodied perspective in the treatment of depression while also aggregating findings on their average efficacy. Methods A systematic review was carried out on RCTs comparing psychodynamic psychotherapy (PDP) addressing the subjective body to control conditions or bona fide therapies, the latter are therapies that have shown their efficacy in a broad context already. Outcomes were analyzed quantitatively using random effects models. The main characteristics of the applied treatment models were summarized narratively from the underlying intervention descriptions. Findings on the treatment models were structured in clusters according to their theoretical embedding. Results Eleven Trials matched the inclusion criteria with a total of 1,624 patients. Post treatment PDP addressing the subjective body differed from control conditions with a standardized mean difference (SMD) = −0.53 [ p = 0.017, 95% CI (−0.97, −0.09), I 2 = 89.12%]. At follow-up differences to control conditions remained to be present with SMD = −1.23 [ p = 0.005, 95% CI (−2.10, −0.35), I 2 = 90.35%]. Compared to bona fide therapies no differences were detected post-treatment when applying two-one-sided-tests [SMD = 0.08, p = 0.039, 90% CI (−0.064, 0.23)]. Throughout the applied interventions three overarching technical principles were identified. Concurrently marked differences existed. Conclusion The findings of our study suggest that PDPs addressing the subjective body are potentially efficacious. However, further conceptual elaboration on embodied treatment techniques is necessary. Subsequent studies should, in addition, scrutinize the contribution that these specific interventions make at the process and outcome level. Systematic review registration PROSPERO, identifier (CRD42024523337).