title: Effectiveness of short-term and long-term psychotherapy on work ability and functional capacity--a randomized clinical trial on depressive and anxiety disorders.
abstract: BACKGROUND
  Insufficient evidence exists about the effect of different therapies on work ability for patients with psychiatric disorders. The present study compares improvements in work ability in two short-term therapies and one long-term therapy.
  
  
  METHODS
  In the Helsinki Psychotherapy Study, 326 outpatients with depressive or anxiety disorder were randomly assigned to long-term and short-term psychodynamic psychotherapy, and solution-focused therapy. The patients were followed for 3 years from the start of treatment. Primary outcome measures were the Work Ability Index (WAI), the Work-subscale (SAS-Work) of the Social Adjustment Scale (SAS-SR), Perceived Psychological Functioning Scale, the prevalence of patients employed or studying, and the number of sick-leave days.
  
  
  RESULTS
  Work ability was statistically significantly improved according to WAI (15%), SAS-Work (17%), and Perceived Psychological Functioning Scale (21%) during the 3-year follow-up. No differences in the work ability scores were found between two short-term therapies. The short-term therapies showed 4-11% more improved work ability scores than long-term therapy at the 7 month follow-up point. During the second year of follow-up, no significant differences were found between therapies. After 3 years of follow-up, long-term therapy was more effective than the short-term therapies with 5-12% more improved scores. No differences in the prevalence of individuals employed or studying or in the number of sick-leave days were found between therapies during follow-up.
  
  
  CONCLUSIONS
  Short-term therapies give benefits more quickly than long-term therapy on work ability but in the long run long-term therapy is more effective than short-term therapies. More research is needed to confirm these findings.
authors.affiliation: Social Insurance Institution, Helsinki, Finland. paul.knekt@ktl.fi
authors.forename: Paul
authors.initials: P
authors.lastname: Knekt
authors.forename: Olavi
authors.initials: O
authors.lastname: Lindfors
authors.forename: Maarit A
authors.initials: MA
authors.lastname: Laaksonen
authors.forename: Raimo
authors.initials: R
authors.lastname: Raitasalo
authors.forename: Peija
authors.initials: P
authors.lastname: Haaramo
authors.forename: Aila
authors.initials: A
authors.lastname: Järvikoski
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D010352:Patient Dropouts; D011613:Psychotherapy / Q000379:methods*; D011614:Psychotherapy, Brief / Q000379:methods; D012655:Self-Evaluation Programs; D018582:Sick Leave / Q000706:statistics & numerical data; D012917:Social Adjustment; D016896:Treatment Outcome; D014937:Work / Q000502:physiology / Q000523:psychology*; D014938:Work Capacity Evaluation