title: Effects of Scheduled Waiting for Psychotherapy in Patients With Major Depression.
abstract: The role of nonspecific factors in the outcome of psychotherapy is poorly understood. To study the effects of pretreatment expectancy of scheduled psychotherapy, we examined the effects of an agreed waiting time on the outcome of psychodynamic psychotherapy. Thirty-three treatment-naive outpatients with major depressive disorder were randomly selected to start psychotherapy either directly (DG; n = 17) or after waiting for 6 months (WG; n = 16). In WG, 18% to 60% of the total decline in symptoms took place during the waiting time. After 1 year of active psychotherapy, the anxiety score declined significantly only in WG, and the total length of treatment needed was shorter in WG. No other outcome differences between WG and DG were found. We conclude that scheduled waiting associates with a significant decline in depressive symptoms. Scheduled waiting should be regarded as a preparatory treatment and not as an inert nontreatment control.
authors.affiliation: *Department of Psychiatry, Kuopio University Hospital; †Institute of Clinical Medicine, Discipline of Psychiatry, University of Eastern Finland; ‡Department of Forensic Psychiatry, University of Eastern Finland, Kuopio; §National Institute for Health and Welfare, Helsinki; ‖Kuopio Psychiatric Center, Kuopio, Finland; ¶Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and #Institute of Clinical Medicine/Psychiatry and the Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
authors.forename: Pasi
authors.initials: P
authors.lastname: Ahola
authors.forename: Mikko
authors.initials: M
authors.lastname: Joensuu
authors.forename: Paul
authors.initials: P
authors.lastname: Knekt
authors.forename: Olavi
authors.initials: O
authors.lastname: Lindfors
authors.forename: Pirjo
authors.initials: P
authors.lastname: Saarinen
authors.forename: Tommi
authors.initials: T
authors.lastname: Tolmunen
authors.forename: Minna
authors.initials: M
authors.lastname: Valkonen-Korhonen
authors.forename: Tuija
authors.initials: T
authors.lastname: Jääskeläinen
authors.forename: Esa
authors.initials: E
authors.lastname: Virtala
authors.forename: Jari
authors.initials: J
authors.lastname: Tiihonen
authors.forename: Johannes
authors.initials: J
authors.lastname: Lehtonen
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D013997:Time Factors; D014850:Waiting Lists; D055815:Young Adult