精神動力學和分析心理療法在日常護理中的長期療效：一項為期6年的自然觀察研究結果 The long-term effectiveness of psychodynamic and analytical psychotherapy in routine care: Results from a naturalistic study over 6 years ——《諮詢與臨床心理學雜誌》第93卷第12期，2025年12月—— <Journal of Consulting and Clinical Psychology> Volume 93, Issue 12, December 2025 【摘要】目的：本自然觀察研究旨在考察兩種以精神分析為導向的療法——精神動力學心理療法（PP）和分析心理療法（AP）——在德國常規醫療機構中的長期療效。方法：共有428名根據《精神疾病診斷與統計手冊》（第四版）診斷為各種精神障礙的患者接受了PP或AP治療。治療結束後重新評估了診斷結果，並在6年期間每年收集患者的心理健康自評報告。我們採用傾向評分法和分段線性潛在增長曲線模型來評估治療對主要結局指標（即診斷數量、症狀困擾程度）和次要結局指標（即人格功能障礙、人際關係問題、總體生活滿意度）的影響。結果：兩種療法均使患者在所有結局指標上表現出顯著且持續的改善。值得注意的是，與PP組相比，AP組患者在主要結局指標和大多數次要結局指標上獲得了更大的（長期）改善。 PP組的改善主要發生在第一年，而AP組患者在整個觀察期內持續取得進步。對於某些結局指標（症狀困擾、人格功能障礙和人際關係問題），AP組對基線時問題更嚴重的患者尤其有效。結論：在常規護理中採用精神分析取向的治療可帶來顯著且持久的改善，即使在治療結束後也是如此。我們的研究結果強調了AP組相對於PP組的額外優勢，尤其是在複雜病例中。未來的研究應探索治療機制、成本效益以及對衛生政策的影響。 【關鍵詞】精神分析取向的心理治療；自然觀察研究；長期心理治療；長期療效；常規護理 [Abstract] Objective: This naturalistic 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 mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, 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 6-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 diagnoses, symptom distress) and secondary outcomes (i.e., 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 most secondary outcomes compared to those in PP. Improvements in PP primarily occurred during the 1st 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 posttreatment. 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. [Key words] psychoanalytically oriented psychotherapy; naturalistic study; long-term psychotherapy; long-term effectiveness; routine care 論文原文：Miriam Henkel, Johannes Zimmermann, Matthias Volz, Dorothea Huber, Hermann Staats, Cord Benecke (2025). The long-term effectiveness of psychodynamic and analytical psychotherapy in routine care: Results from a naturalistic study over 6 years. Journal of Consulting and Clinical Psychology, Volume 93, Issue 12, Pages 814–828. December 2025. https://doi.org/10.1037/ccp0000985 （需要英文原文的朋友，請聯繫微信：millerdeng95或iacmsp）
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