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To the Editor: In their meta-analysis on the effectiveness of LTPP, Drs Leichsenring and Rabung¹ reported evidence that LTPP is an effective treatment for complex mental disorders. Although the article addressed several limitations of the findings, other limitations should be considered as well.

First, Leichsenring and Rabung formulated an unconventionally broad research question. Systematic review objectives typically define the patient population, intervention, control treatment, outcomes, and study designs of interest.² These authors defined the patient population broadly as a group of adults with mental disorders. The sole criterion that outcomes should have fulfilled is that they were reliable. Control treatments were not defined at all. Thus, analyzed diagnoses, outcomes, and control groups showed a very large clinical heterogeneity. Although the reviewers tried to account for this through subgroup analyses, their method of building clusters of heterogeneous disorders and outcomes still allowed for considerable variation. Thus, it is unclear for what . . . [Full Text of this Article]

Levente Kriston, PhD
l.kriston@uke.uni-hamburg.de
Department of Medical Psychology
University Medical Center Hamburg-Eppendorf
Hamburg, Germany

Lars Hölzel, MA
Department of Psychiatry and Psychotherapy
University Medical Center Freiburg
Freiburg, Germany

Martin Härter, MD, PhD
Department of Medical Psychology
University Medical Center Hamburg-Eppendorf
Hamburg

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