- Design
- Single-centre, assessor-blinded, parallel-group randomised trial
- Population
- 130 outpatients with schizophrenia or schizoaffective disorder
- Primary outcome
- Psychosocial functioning (Mini-ICF-APP) at 24 and 36 months
- Effect
- Difference -3.45 (95% CI -5.51 to -1.40) at 24 months; -4.07 (-6.19 to -1.94) at 36 months
A single-centre, assessor-blinded randomised trial in Berlin allocated 130 outpatients with schizophrenia or schizoaffective disorder to a manualised psychodynamic therapy (at least 30 sessions) plus usual care, or usual care alone.
The primary outcome was psychosocial functioning on the Mini-ICF-APP. At 24 months the adjusted between-group difference was -3.45 (95% CI -5.51 to -1.40) and at 36 months -4.07 (-6.19 to -1.94), favouring the therapy. Adverse events were similar; two participants died by suicide, one in each group.
Participants and therapists could not be blinded, only assessors, and it was one centre with a modest sample. The authors suggest a possible role alongside other psychosocial treatments. It is encouraging evidence for a long-standing practice, not yet a reason to replace established psychosocial options.
- Consider interpersonal functioning as a treatment target, not only positive symptoms.
- This therapy needs 30 or more sessions; check access and capacity before recommending it.
- It was tested added to usual care, not instead of medication or other psychosocial options.
- Await replication in other centres before changing service pathways.
Why it matters
It gives a long-used therapy its first sizeable randomised evidence for functioning in schizophrenia.
Don't overread it
Single-centre and open to therapist and participant expectation; the abstract does not give a threshold for a meaningful change.
The statistics, in plain English
A difference of about 3 to 4 points on a functioning scale is statistically clear here, but whether it is noticeable to a patient depends on the scale's clinically important difference, which the abstract does not give.
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