title: 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.
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.
  
  
  METHODS
  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.
authors.affiliation: Social Insurance Institution, Helsinki, Finland. paul.knekt@ktl.fi
authors.forename: P
authors.initials: P
authors.lastname: Knekt
authors.forename: O
authors.initials: O
authors.lastname: Lindfors
authors.forename: T
authors.initials: T
authors.lastname: Härkänen
authors.forename: M
authors.initials: M
authors.lastname: Välikoski
authors.forename: E
authors.initials: E
authors.lastname: Virtala
authors.forename: M A
authors.initials: MA
authors.lastname: Laaksonen
authors.forename: M
authors.initials: M
authors.lastname: Marttunen
authors.forename: M
authors.initials: M
authors.lastname: Kaipainen
authors.forename: C
authors.initials: C
authors.lastname: Renlund
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008134:Long-Term Care; D008297:Male; D010352:Patient Dropouts / Q000523:psychology; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory; D011340:Problem Solving; D011575:Psychoanalytic Therapy / Q000379:methods*; D011614:Psychotherapy, Brief / Q000379:methods*