Effectiveness of short-term and long-term psychotherapy on work ability and functional capacity--a randomized clinical trial on depressive and anxiety disorders.
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.
Knekt
Paul
P
Social Insurance Institution, Helsinki, Finland. paul.knekt@ktl.fi
Lindfors
Olavi
O
Laaksonen
Maarit A
MA
Raitasalo
Raimo
R
Haaramo
Peija
P
Järvikoski
Aila
A
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