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Hautzinger, Martin; Leuzinger-Bohleber, Marianne; Fiedler, Georg; Bahrke, Ulrich; Kallenbach-Kaminski, Lisa; Kaufhold, Johannes; Ernst, Mareike; Hegele, Alexa; Schoett, Margarete; Kuechenhoff, Helmut; Guenther, Felix; Rueger, Bernhard and Beutel, Manfred (2019): Was sagt die LAC-Depressionsstudie nun wirklich aus?Erwiderung auf die methodenkritischen Betrachtungen. In: Psychotherapeut, Vol. 65, No. 1: pp. 27-31

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The detailed reply by Kaiser et al. to the article reports on the first controlled psychotherapy study to compare long-term psychoanalytic and cognitive behavioral therapies with randomized and preferential allocation. At 4 treatment centers 554 chronically depressive patients were interviewed;ultimately, 252 of them were included in the study. The patients' self-assessments (Beck depression inventory, BDI) indicated major and stable changes. After 1 year the complete remission rate was 34%, increasing to 45% after 3 years. The effect strengths were d= 1.17 after 1 year and 1.83 after 3 years. Similar outcomes were indicated by the assessments by independent raters blinded to the therapeutic procedure (quick inventory of depressive symptomatology, QIDS: remission rates were 39% after 1 year, 61% after 3 years, effect strengths d= 1.56 after 1 year, 2.08 after 3 years). In contrast to their expectations, the authors found no statistically significant differences between the therapeutic procedures with respect to reduction of symptoms and also no effect differences between randomized therapy allocation and treatment via preferential psychotherapy;however, differences were found with respect to structural alterations (measured with operationalized psychodynamic diagnostics 2, OPD-2). More patients in psychoanalytic therapy (PAT) showed structural alterations than in cognitive behavioral therapy (CBT) 3 years after beginning treatment. In addition, these structural alterations in PAT had a stronger influence on the symptom alteration in comparison to CBT. Previous publications concerned T0 data as well as conceptual and clinical considerations. The outcome results were first published in the main publications in 2019 in English and German. A unique feature of the study was the evaluation of the data by an independent methodological center (Statistical Consulting Center, UnitStaBLab, University of Munich), which refuted the methodological objections raised by Kaiser et al. in their response. As with all studies, the LAC study also has its limitations, as the authors discuss in detail in the key publications.

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