{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T03:17:04Z","timestamp":1767151024703,"version":"build-2238731810"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"unspecified","delay-in-days":202,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291725101025_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Providing psychotherapy at 50 sessions in a year (starting twice weekly) led to faster and greater improvements in depression and personality functioning compared to 25 sessions, starting weekly for patients with depression and personality disorder (PD). This study reports long-term dosage effects at 18 and 24\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291725101025_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a pragmatic, double-randomized clinical trial, 246 outpatients with depression and PD were assigned to (1) 25 or 50 sessions and (2) Short-term Psychodynamic Supportive Psychotherapy (SPSP) or Schema Therapy (ST). Depression severity was assessed with the Beck Depression Inventory-II. Secondary outcomes included diagnostic remission of depression (MINI-plus), PD (SCID-II\/SCID-5-P), and treatment-specific measures. Intention-to-treat analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291725101025_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 18 and 24\u00a0months, BDI-II means did not differ between dosage groups (19.0 for 25 sessions versus 19.1 for 50 sessions;\n                      <jats:italic>d\u00a0=<\/jats:italic>\n                      \u00a0\u22120.01; 95% CI\u00a0=\u00a0\u22120.35-0.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.96). The lower-dosage group improved during follow-up (\u22122.6 BDI points,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.031), which may be partly attributed to additional therapy received by a subgroup. Remission rates at 24\u00a0months were 66% for depression and 76% for PD, with no differences between conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291725101025_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher psychotherapy dosage led to faster initial improvements, but long-term outcomes were not superior to those achieved with a lower dosage. These results should be interpreted with caution, as unregulated treatment during follow-up reduced the power to detect significant dosage effects. Both SPSP and ST provide viable alternatives to treatments focused solely on depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291725101025","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T08:22:28Z","timestamp":1753172548000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Long-term dosage effects of psychodynamic and schema therapy in depressed patients with personality disorders: 18 and 24\u00a0months follow-up of a randomized controlled trial"],"prefix":"10.1017","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4862-8310","authenticated-orcid":false,"given":"Marit","family":"Kool","sequence":"first","affiliation":[{"name":"Arkin Foundation: Stichting Arkin"},{"name":"Vrije Universiteit Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"van den Eshof","sequence":"additional","affiliation":[{"name":"Arkin Foundation: Stichting Arkin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rien","family":"Van","sequence":"additional","affiliation":[{"name":"Arkin Foundation: Stichting Arkin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Dekker","sequence":"additional","affiliation":[{"name":"Arkin Foundation: Stichting Arkin"},{"name":"Vrije Universiteit Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaap","family":"Peen","sequence":"additional","affiliation":[{"name":"Arkin Foundation: Stichting Arkin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnoud","family":"Arntz","sequence":"additional","affiliation":[{"name":"University of Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"S0033291725101025_r20","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1829-1"},{"key":"S0033291725101025_r36","unstructured":"Veenhoven, R. Happiness Questionnaire (2014). Available from: http:\/\/worlddatabaseofhappiness.eur.nl\/hap_quer\/hqs_fp.htm."},{"key":"S0033291725101025_r29","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000557VeenhovenR"},{"key":"S0033291725101025_r22","first-page":"191","volume-title":"The use of psychological testing for treatment planning and outcomes assessment: Volume 3: Instruments for adults","author":"Lambert","year":"2004"},{"key":"S0033291725101025_r30","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.20.1.23"},{"key":"S0033291725101025_r1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1176355"},{"key":"S0033291725101025_r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.05.070"},{"key":"S0033291725101025_r16","volume-title":"Trimbos\/iMTA questionnaire for costs with psychiatric illness (TIC-P)","author":"Hakkaart-van Roijen","year":"2002"},{"key":"S0033291725101025_r6","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.265"},{"key":"S0033291725101025_r18","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.1.191-b"},{"key":"S0033291725101025_r5","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291723002143"},{"key":"S0033291725101025_r34","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.110.082776"},{"key":"S0033291725101025_r21","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2024.56"},{"key":"S0033291725101025_r12","doi-asserted-by":"publisher","DOI":"10.1080\/07351690.2013.835184"},{"key":"S0033291725101025_r17","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.59.1.12"},{"key":"S0033291725101025_r13","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700048017"},{"key":"S0033291725101025_r3","volume-title":"Beck depression inventory-II: Manual","author":"Beck","year":"1996"},{"key":"S0033291725101025_r15","volume-title":"SCID-5-PD: Structured clinical interview for DSM-5 personality disorders","author":"First","year":"2016"},{"key":"S0033291725101025_r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2018.07.005"},{"key":"S0033291725101025_r10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.02.030"},{"key":"S0033291725101025_r19","doi-asserted-by":"publisher","DOI":"10.1002\/da.22491"},{"key":"S0033291725101025_r27","doi-asserted-by":"publisher","DOI":"10.1139\/jpn.0242"},{"key":"S0033291725101025_r23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2021.11.039"},{"key":"S0033291725101025_r31","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.75.3.475"},{"key":"S0033291725101025_r33","volume-title":"Young schema questionnaire-short form; version 3","author":"Young","year":"2005"},{"key":"S0033291725101025_r25","first-page":"166","article-title":"Treatment for chronic depression using schema therapy","volume":"20","author":"Renner","year":"2013","journal-title":"Clinical Psychology: Science and Practice"},{"key":"S0033291725101025_r35","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.jad.2020.12.122","article-title":"Exploring differences in quality of life in clinical populations of depressed outpatients with and without personality disorders","volume":"282","author":"Kool","year":"2021","journal-title":"J Affect Disord"},{"key":"S0033291725101025_r14","volume-title":"Structured clinical interview for DSM-IV II personality disorders (SCID-II)","author":"First","year":"1997"},{"key":"S0033291725101025_r2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12040518"},{"key":"S0033291725101025_r24","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000323"},{"key":"S0033291725101025_r26","volume-title":"Mini international neuropsychiatric interview plus","author":"Sheehan","year":"2000"},{"key":"S0033291725101025_r28","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721000878"},{"key":"S0033291725101025_r32","volume-title":"The schema mode inventory","author":"Young","year":"2007"},{"key":"S0033291725101025_r4","volume-title":"The measurement and valuation of health status using EQ-5D: A European perspective: Evidence from the EuroQol BIOMED research programme","author":"Brooks","year":"2013"},{"key":"S0033291725101025_r11","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21203"}],"updated-by":[{"DOI":"10.1017\/s003329172510189x","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000}}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291725101025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T01:40:54Z","timestamp":1758678054000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291725101025\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":35,"alternative-id":["S0033291725101025"],"URL":"https:\/\/doi.org\/10.1017\/s0033291725101025","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e210"}}