Send to

Choose Destination
Harv Rev Psychiatry. 2013 May-Jun;21(3):107-37. doi: 10.1097/HRP.0b013e318294f5fd.

The current state of the empirical evidence for psychoanalysis: a meta-analytic approach.

Author information

Vrije Universiteit Amsterdam, Nederlands Psychoanalytisch Instituut, Arkin, Amsterdam, the Netherlands.



After participating in this educational activity, the reader should be better able to evaluate the empirical evidence for pre/post changes in psychoanalysis patients with complex mental disorders, and assess the limitations of the meta-analysis.


The effectiveness of psychoanalysis is still a controversial issue, despite increasing research efforts.


To investigate the empirical evidence for psychoanalysis by means of a systematic review of the literature and a meta-analysis of the research data.


A systematic literature search was undertaken to find studies regarding the effectiveness of psychoanalysis, published between 1970 and 2011. A meta-analysis was performed.


Fourteen studies (total n = 603) were included in the meta-analysis. All but one were pre/post cohort studies. At treatment termination, the mean pre/post effect size across all outcome measures was 1.27 (95% confidence interval [CI], 1.03-1.50; p < .01). The mean pre/post effect size for symptom improvement was 1.52 (95% CI, 1.20-1.84; p < .01), and for improvement in personality characteristics 1.08 (95% CI, 0.89-1.26; p < .01). At follow-up the mean pre/follow-up effect size was 1.46 across all outcome measures (95% CI, 1.08-1.83; p < .01), 1.65 for symptom change (95% CI, 1.24-2.06; p < .01), and 1.31 for personality change (95% CI, 1.00-1.62; p < .01).


A limited number of mainly pre/post studies, presenting mostly completers analyses, provide empirical evidence for pre/post changes in psychoanalysis patients with complex mental disorders, but the lack of comparisons with control treatments is a serious limitation in interpreting the results. Further controlled studies are urgently needed.

[Indexed for MEDLINE]

Supplemental Content

Loading ...
Support Center