Letter to the editor: Serious concerns about 'Concerns over the process and outcomes of the review by the Royal Australian and New Zealand College of Psychiatrists into long-term psychodynamic psychotherapy'.

The article addresses criticisms by Kisely and Malhi regarding a review of long-term psychodynamic psychotherapy (LTPP) for depression, commissioned by the Royal Australian and New Zealand College of Psychiatrists (RANZCP). It clarifies that the review adhered to its pre-registered protocol, appropriately distinguished between within-group and between-group analyses, and acknowledged the complexity and comorbidity common in depression, including borderline personality disorder. The authors defend the inclusion of heterogeneous treatments and control conditions, noting that such diversity is typical in psychotherapy research, and emphasize that adverse effects were discussed in the review. They also respond to concerns about potential bias in qualitative studies by highlighting additional meta-syntheses conducted. The article concludes by underscoring the importance of developing effective treatments like LTPP for complex depression, regardless of diagnostic categories.