title: Use of auxiliary psychiatric treatment during a 5-year follow-up among patients receiving short- or long-term psychotherapy.
abstract: BACKGROUND
  The need for treatment is, despite of its obvious usefulness, a scarcely used measure of effectiveness in psychotherapy trials. This study considers changes in the need for auxiliary psychiatric treatment after starting short- and long-term psychotherapy and psychoanalysis.
  
  
  METHODS
  Altogether 326 psychiatric outpatients with mood or anxiety disorder were randomly assigned to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP), or long-term psychodynamic psychotherapy (LPP) while 41 self-selected patients were allocated to psychoanalysis (PA). The patients were followed for 5 years from start of treatment. Outcome measures were use of auxiliary psychotherapy, psychotropic medication, and hospitalization for mental reasons.
  
  
  RESULTS
  About 60% of the patients used auxiliary treatment during the follow-up. It was most common in the short-term therapy groups and its incidence was highest during the first year after the start of therapy. The average numbers of all therapy sessions among patients starting the therapy were 60, 70, 240, and 670 in SFT, SPP, LPP, and PA, respectively, whereas the corresponding average numbers of study therapy sessions alone were 10, 19, 232, and 646. Over 50% of the patients receiving short-term therapy received on average 4-6 times more therapy sessions than initially assigned.
  
  
  CONCLUSIONS
  Post-randomization withdrawal was uneven.
  
  
  CONCLUSIONS
  Auxiliary treatment is usual among patients receiving short- and long-term therapies, and apparently becomes common shortly after the start of treatment. Auxiliary treatment can be used as an outcome measure indicating the need for treatment, should be monitored clinically and considered when interpreting the results of effectiveness studies.
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland. paul.knekt@thl.fi
authors.forename: Paul
authors.initials: P
authors.lastname: Knekt
authors.forename: Olavi
authors.initials: O
authors.lastname: Lindfors
authors.forename: Camilla
authors.initials: C
authors.lastname: Renlund
authors.forename: Laura
authors.initials: L
authors.lastname: Sares-Jäske
authors.forename: Maarit A
authors.initials: MA
authors.lastname: Laaksonen
authors.forename: Esa
authors.initials: E
authors.lastname: Virtala
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D019964:Mood Disorders / Q000628:therapy*; D011572:Psychoanalysis; D011613:Psychotherapy / Q000379:methods; D011614:Psychotherapy, Brief / Q000379:methods*; D011615:Psychotherapy, Group; D016896:Treatment Outcome; D055815:Young Adult