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Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up

Published online by Cambridge University Press:  16 November 2007

P. Knekt ,
O. Lindfors ,
T. Härkänen ,
M. Välikoski ,
E. Virtala ,
M. A. Laaksonen ,
M. Marttunen ,
M. Kaipainen  and
C. Renlund
P. Knekt*
Affiliation:
Social Insurance Institution, Helsinki, Finland Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
O. Lindfors
Affiliation:
Biomedicum Helsinki, Helsinki, Finland
T. Härkänen
Affiliation:
Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
M. Välikoski
Affiliation:
Biomedicum Helsinki, Helsinki, Finland
E. Virtala
Affiliation:
Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
M. A. Laaksonen
Affiliation:
Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
M. Marttunen
Affiliation:
Biomedicum Helsinki, Helsinki, Finland
M. Kaipainen
Affiliation:
Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
C. Renlund
Affiliation:
Biomedicum Helsinki, Helsinki, Finland
*
*Address for correspondence: Dr P. Knekt, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki, Finland. (Email: paul.knekt@ktl.fi)
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Abstract

Background

Insufficient evidence exists for a viable choice between long- and short-term psychotherapies in the treatment of psychiatric disorders. The present trial compares the effectiveness of one long-term therapy and two short-term therapies in the treatment of mood and anxiety disorders.

Method

In the Helsinki Psychotherapy Study, 326 out-patients with mood (84.7%) or anxiety disorder (43.6%) were randomly assigned to three treatment groups (long-term psychodynamic psychotherapy, short-term psychodynamic psychotherapy, and solution-focused therapy) and were followed up for 3 years from start of treatment. Primary outcome measures were depressive symptoms measured by self-report Beck Depression Inventory (BDI) and observer-rated Hamilton Depression Rating Scale (HAMD), and anxiety symptoms measured by self-report Symptom Check List Anxiety Scale (SCL-90-Anx) and observer-rated Hamilton Anxiety Rating Scale (HAMA).

Results

A statistically significant reduction of symptoms was noted for BDI (51%), HAMD (36%), SCL-90-Anx (41%) and HAMA (38%) during the 3-year follow-up. Short-term psychodynamic psychotherapy was more effective than long-term psychodynamic psychotherapy during the first year, showing 15–27% lower scores for the four outcome measures. During the second year of follow-up no significant differences were found between the short-term and long-term therapies, and after 3 years of follow-up long-term psychodynamic psychotherapy was more effective with 14–37% lower scores for the outcome variables. No statistically significant differences were found in the effectiveness of the short-term therapies.

Conclusions

Short-term therapies produce benefits more quickly than long-term psychodynamic psychotherapy but in the long run long-term psychodynamic psychotherapy is superior to short-term therapies. However, more research is needed to determine which patients should be given long-term psychotherapy for the treatment of mood or anxiety disorders.

Keywords

Anxietydepressionlong-termpsychotherapyrandomized trial
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 5 , May 2008 , pp. 689 - 703
Copyright
Copyright © Cambridge University Press 2007

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