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To the Editor: The meta-analysis by Drs Leichsenring and Rabung¹ concluded that LTPP is an effective treatment for complex mental disorders. However, there are some critical aspects of this research that were not considered.

First, 2 studies categorized as RCTs in the meta-analysis,^2-3 representing more than half of the total patient count in the RCT group, had no control condition other than LTPP. These 2 studies were not designed to answer the question of whether LTTP is more effective than other (shorter) psychotherapeutic treatments; thus the studies provide no additional information compared with observational studies.

Second, TAU was included in the group of other psychotherapy methods, weakening the effect of these alternative methods. Of these alternative methods, a large number were based on psychodynamic theories.

Third, the studies of treatment of borderline personality disorder indicate that manualized LTPP is superior to TAU. However, in the active treatment comparison, a study . . . [Full Text of this Article]

Stefan Roepke, MD
stefan.roepke@charite.de
Department of Psychiatry and Psychotherapy
Charité-University Medicine Berlin
Berlin, Germany

Babette Renneberg, PhD
Free University Berlin
Berlin

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