Psychological Predictors on the Outcome of Short-Term Psychodynamic Psychotherapy and Solution-Focused Therapy in the Treatment of Mood and Anxiety Disorder

2012 ◽  
Vol 28 (2) ◽  
pp. 117-124 ◽  
Author(s):  
M.A. Laaksonen ◽  
P. Knekt ◽  
L. Sares-Jäske ◽  
O. Lindfors
Keyword(s):  
Anxiety Disorder ◽  
Psychodynamic Psychotherapy ◽  
Psychiatric Symptoms ◽  
Psychotherapy Outcomes ◽  
Short Term ◽  
Good Score ◽  
Pre Treatment ◽  
Solution Focused ◽  
Solution Focused Therapy

AbstractObjectivePatient's pre-treatment suitability for short-term psychodynamic psychotherapy (STPP) and solution-focused therapy (SFT) has not been compared. The aim of this study was to compare the prediction of psychological suitability measures on outcome of STPP vs. SFT.MethodAltogether 198 patients with mood or anxiety disorder were randomized to STPP or SFT. A 7-item Suitability for Psychotherapy Scale (SPS) was assessed at baseline and a cumulative SPS score was formed. Psychiatric symptoms were measured using SCL-90-GSI at baseline and seven times during a 3-year follow-up.ResultsThe SPS score predicted the outcome of both short-term psychotherapies; for patients with a good score short-term therapies seemed beneficial, whereas for patients with a poor score they did not seem sufficient. There was no difference between STPP and SFT in the prediction of the SPS score.ConclusionsPsychological suitability measures may apparently be useful in the prediction of overall short-term psychotherapy outcomes.

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

2007 ◽  
Vol 38 (5) ◽  
pp. 689-703 ◽  
Author(s):  
P. Knekt ◽  
O. Lindfors ◽  
T. Härkänen ◽  
M. Välikoski ◽  
E. Virtala ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Outcome Measures ◽  
Psychodynamic Psychotherapy ◽  
Rating Scale ◽  
Self Report ◽  
Short Term ◽  
Solution Focused ◽  
Solution Focused Therapy

BackgroundInsufficient 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.MethodIn 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).ResultsA 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.ConclusionsShort-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.

The Effectiveness of Three Psychotherapies of Different type and Length in the Treatment of Patients Suffering from Anxiety Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s777-s777
Author(s):  
P. Knekt ◽  
O. Lindfors ◽  
T. Maljanen
Keyword(s):  
Anxiety Disorder ◽  
Work Ability ◽  
Psychodynamic Psychotherapy ◽  
Cost Effective ◽  
Term Therapy ◽  
Short Term ◽  
Number Of Patients ◽  
Axis I

IntroductionData on the comparative effect of short and long-term psychotherapy in anxiety disorder is scarce.AimTo compare the effectiveness of two short-term therapies and one long-term psychotherapy in the treatment of patients with anxiety disorder.MethodsAltogether 50 outpatients with anxiety disorder as the only axis I diagnosis, were randomly assigned to long-term psychodynamic psychotherapy (LPP), short-term psychodynamic psychotherapy (SPP), and solution-focused therapy (SFT) and were followed for 5 years. The outcome measures were psychiatric symptoms, working ability, need for psychiatric treatment, remission, and cost-effectiveness.ResultsDuring the first year of follow-up, no significant differences in the effectiveness between the therapies were noted. During the following 3 years, LPP and SFT more effectively reduced symptoms, improved work ability, and elevated the remission rate than SPP. No significant differences between LPP and SFT were seen. At the end of the follow-up, the use of auxiliary treatment was lowest in the SFT group whereas remission rates or changes in psychiatric symptom or work ability did not differ between the groups. The average total direct costs were about three times higher in the LPP group than in the short-term therapy groups.ConclusionsThe difference in effectiveness of LPP and SFT was negligible, whereas SPP appeared less effective. Thus, the resource-oriented SFT may be a cost-effective option in this selected patient group, while unconsidered allocation of patients to LPP does not appear to be cost-effective. Given the small number of patients, no firm conclusions should, however be drawn based on this study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The outcome of short- and long-term psychotherapy 10 years after start of treatment

2016 ◽  
Vol 46 (6) ◽  
pp. 1175-1188 ◽  
Author(s):  
P. Knekt ◽  
E. Virtala ◽  
T. Härkänen ◽  
M. Vaarama ◽  
J. Lehtonen ◽  
...  
Keyword(s):  
Work Ability ◽  
Psychodynamic Psychotherapy ◽  
Psychiatric Symptoms ◽  
Term Therapy ◽  
Short Term ◽  
Treatment Standards ◽  
Remission Rates ◽  
Short Term Therapy

BackgroundEmpirical evidence on whether patients’ mental health and functioning will be more improved after long-term than short-term therapy is scarce. We addressed this question in a clinical trial with a long follow-up.MethodIn the Helsinki Psychotherapy Study, 326 out-patients with mood or anxiety disorder were randomly assigned to long-term psychodynamic psychotherapy (LPP), short-term psychodynamic psychotherapy (SPP) or solution-focused therapy (SFT) and were followed for 10 years. The outcome measures were psychiatric symptoms, work ability, personality and social functioning, need for treatment, and remission.ResultsAt the end of the follow-up, altogether 74% of the patients were free from clinically elevated psychiatric symptoms. Compared with SPP, LPP showed greater reductions in symptoms, greater improvement in work ability and higher remission rates. A similar difference in symptoms and work ability was observed in comparison with SFT after adjustment for violations of treatment standards. No notable differences in effectiveness between SFT and SPP were observed. The prevalence of auxiliary treatment was relatively high, 47% in SFT, 58% in SPP and 33% in LPP, and, accordingly, the remission rates for general symptoms were 55, 45 and 62%, respectively.ConclusionsAfter 10 years of follow-up, the benefits of LPP in comparison with the short-term therapies are rather small, though significant in symptoms and work ability, possibly due to more frequent use of auxiliary therapy in the short-term therapy groups. Further studies should focus on the choice of optimal length of therapy and the selection of factors predicting outcome of short- v. long-term therapy.

Changes in lifestyle for psychiatric patients three years after the start of short- and long-term psychodynamic psychotherapy and solution-focused therapy

2010 ◽  
Vol 25 (1) ◽  
pp. 1-7 ◽  
Author(s):  
P. Knekt ◽  
M.A. Laaksonen ◽  
R. Raitasalo ◽  
P. Haaramo ◽  
O. Lindfors
Keyword(s):  
Alcohol Consumption ◽  
Serum Cholesterol ◽  
Psychodynamic Psychotherapy ◽  
Psychiatric Patients ◽  
Lifestyle Changes ◽  
Term Therapy ◽  
Short Term ◽  
Solution Focused ◽  
Solution Focused Therapy

AbstractObjectivesLifestyle is less favourable among individuals suffering from psychiatric disorders. We studied whether psychotherapy brings along changes in lifestyle and whether these changes differ between short-term and long-term psychodynamic psychotherapy (SPP and LPP) and solution-focused therapy (SFT).MethodsA total of 326 outpatients, 20–46 years of age, with mood or anxiety disorder were randomly assigned to LPP, SPP and SFT. The lifestyle variables considered were alcohol consumption, smoking, body mass index (BMI), leisure time exercise and serum cholesterol. The patients were monitored for three years from the start of treatment.ResultsDuring the three-year follow-up, BMI and serum cholesterol rose statistically significantly although no statistically significant trends were shown for alcohol consumption, smoking or exercise. SPP showed a disadvantage of increased alcohol consumption and serum cholesterol level when compared with LPP. SFT showed an advantage of reduced smoking in comparison with SPP.DiscussionSmall therapy-specific changes in lifestyle may be a result from psychotherapy treatment. These lifestyle changes are apparently more common in short-term therapy. More studies are needed to verify these findings.

Prediction of Demographic Factors on the Outcome of Short- and Long-term Psychotherapy

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
K. Joutsenniemi ◽  
O. Lindfors ◽  
M. Laaksonen ◽  
P. Haaramo ◽  
P. Knekt
Keyword(s):  
Anxiety Disorders ◽  
Psychodynamic Psychotherapy ◽  
Psychiatric Symptoms ◽  
Demographic Factors ◽  
Term Therapy ◽  
Short Term ◽  
Short And Long Term ◽  
Long Term Therapy

Background:Demographic factors have been shown to predict the outcome of short-term psychotherapy in the treatment of depressive and anxiety disorders. So far, however, information on the prediction for long- term therapy is missing. to be able to choose an optimal psychotherapy length for the patient, it is essential to know, which demographic factors predict different outcome in short- and long-term therapy.Aim:To compare the prediction of demographic factors on changes in psychiatric symptoms in short- and long-term psychotherapy.Methods:In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term therapy (short-term psychodynamic psychotherapy or solution-focused therapy combined) or long-term psychodynamic psychotherapy. the demographic factors (i.e. age, gender, education, income, and living arrangement) were assessed at baseline by a questionnaire. Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and 7 times during a 3-year follow-up.Results:Demographic factors were found to predict symptom development during follow-up irrespective of baseline symptom level. Female gender, being aged 25 or more, living with a spouse/partner, high education, and medium level personal income predicted benefiting sufficiently from short-term therapy, whereas being aged under 25, medium education, and living with other(s) than a partner or child(ren) predicted the need of long-term therapy.Conclusions:Demographic factors may be a useful tool in the selection of patients for short- and long term therapy.

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