title: Randomized trial on the effectiveness of long- and short-term psychotherapy on psychosocial functioning and quality of life during a 5-year follow-up.
abstract: Knowledge is incomplete on whether long-term psychotherapy is more effective than short-term therapy in treating mood and anxiety disorder, when measured by improvements in psychosocial functioning and life quality. In the Helsinki Psychotherapy Study, 326 outpatients with mood or anxiety disorder were randomized to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP), or long-term psychodynamic psychotherapy (LPP), and followed up for 5 years from the start of treatment. The outcome measures comprised 4 questionnaires on psychosocial functioning, assessing global social functioning (Social Adjustment Scale (SAS-SR), sense of coherence (Sense of Coherence Scale (SOC)), perceived competence (Self-Performance Survey), dispositional optimism (Life Orientation Test (LOT)), and 1 questionnaire assessing quality of life (Life Situation Survey (LSS)). Short-term therapies improved psychosocial functioning and quality of life more than LPP during the first year. The only exceptions were LOT and perceived competence, which did not differ between SPP and LPP. Later in the follow-up, SOC and perceived competence showed significantly more improvement in LPP than in the short-term therapy groups. No direct differences between SFT and SPP were noted. Short-term therapy has consistently more short-term effects on psychosocial functioning and quality of life than LPP, whereas LPP has some additional long-term benefits on psychosocial functioning.
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland; Biomedicum Helsinki, Helsinki, Finland. Electronic address: paul.knekt@thl.fi.
authors.forename: Paul
authors.initials: P
authors.lastname: Knekt
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Erkki
authors.initials: E
authors.lastname: Heinonen
authors.affiliation: University of Lapland, Rovaniemi, Finland.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Härkäpää
authors.affiliation: University of Lapland, Rovaniemi, Finland.
authors.forename: Aila
authors.initials: A
authors.lastname: Järvikoski
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Virtala
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Julius
authors.initials: J
authors.lastname: Rissanen
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Olavi
authors.initials: O
authors.lastname: Lindfors
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland; Biomedicum Helsinki, Helsinki, Finland; University of Lapland, Rovaniemi, Finland; Rehabilitation Foundation, Helsinki, Finland; Social Insurance Institution, Finland.
authors.lastname: Helsinki Psychotherapy Study Group
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory; D011614:Psychotherapy, Brief / Q000379:methods*; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D011788:Quality of Life; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Anxiety; Depression; Psychotherapy