title: Randomized trial on the effectiveness of long- and short-term psychotherapy on psychiatric symptoms and working ability during a 5-year follow-up.
abstract: BACKGROUND
  The information on whether long-term psychotherapy is superior in comparison with short-term therapies during a long time-perspective in the treatment of mood and anxiety disorder is incomplete.
  
  
  OBJECTIVE
  The present study addresses this question in a clinical trial with an exceptionally long follow-up.
  
  
  METHODS
  In the Helsinki Psychotherapy Study, 326 outpatients with mood or anxiety disorder were randomly assigned to long-term psychodynamic psychotherapy and two types of short-term psychotherapy (short-term psychodynamic psychotherapy and solution-focused therapy) and were followed up for 5 years from the start of treatment. The outcome measures were psychiatric symptoms measured by Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Symptom Check List, anxiety scale (SCL-90-Anx), Hamilton Anxiety Rating Scale (HARS) and Symptom Check List, Global Severity Index (SCL-90-GSI), and working ability measured by the Work Ability Index (WAI), the Work-subscale (SAS-Work) of the Social Adjustment Scale (SAS-SR) and the Perceived Psychological Functioning Scale (PPF). Furthermore, remission variables based on changes in psychiatric symptoms and use of auxiliary treatment, were used.
  
  
  RESULTS
  After the 5-year follow-up, the rate of recovery from psychiatric symptoms and the work ability improvement rate remained higher in the long-term therapy group, whereas no differences in the effectiveness of the two short-term therapies of different modalities were found.
  
  
  CONCLUSIONS
  Long-term psychotherapy is more effective than short-term therapy during a long follow-up, suggesting the need for a careful evaluation of suitability to short-term therapy. More research on the long-term effects of psychotherapy in large-scale studies is still needed, however.
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: Laura
authors.initials: L
authors.lastname: Sares-Jäske
authors.forename: Esa
authors.initials: E
authors.lastname: Virtala
authors.forename: Tommi
authors.initials: T
authors.lastname: Härkänen
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014937:Work