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.

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.

scholarly journals Influence of lifestyle risk factors on work ability and sick leave in a general working population in Norway: a 5-year longitudinal study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045678
Author(s):  
Marit Müller De Bortoli ◽  
Inger M. Oellingrath ◽  
Anne Kristin Moeller Fell ◽  
Alex Burdorf ◽  
Suzan J. W. Robroek
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Sick Leave ◽  
Work Ability ◽  
Working Population ◽  
Short Term ◽  
Lifestyle Risk Factors ◽  
Lifestyle Risk

ObjectivesThe aim of this study is to assess (1) whether lifestyle risk factors are related to work ability and sick leave in a general working population over time, and (2) these associations within specific disease groups (ie, respiratory diseases, cardiovascular disease and diabetes, and mental illness).SettingTelemark county, in the south-eastern part of Norway.DesignLongitudinal study with 5 years follow-up.ParticipantsThe Telemark study is a longitudinal study of the general working population in Telemark county, Norway, aged 16 to 50 years at baseline in 2013 (n=7952) and after 5-year follow-up.Outcome measureSelf-reported information on work ability (moderate and poor) and sick leave (short-term and long-term) was assessed at baseline, and during a 5-year follow-up.ResultsObesity (OR=1.64, 95% CI: 1.32 to 2.05) and smoking (OR=1.62, 95% CI: 1.35 to 1.96) were associated with long-term sick leave and, less strongly, with short-term sick leave. An unhealthy diet (OR=1.57, 95% CI: 1.01 to 2.43), and smoking (OR=1.67, 95% CI: 1.24 to 2.25) were associated with poor work ability and, to a smaller extent, with moderate work ability. A higher lifestyle risk score was associated with both sick leave and reduced work ability. Only few associations were found between unhealthy lifestyle factors and sick leave or reduced work ability within disease groups.ConclusionLifestyle risk factors were associated with sick leave and reduced work ability. To evaluate these associations further, studies assessing the effect of lifestyle interventions on sick leave and work ability are needed.

Long-term effects of warren ripping for rabbit control in semi-arid South Australia.

1991 ◽  
Vol 13 (2) ◽  
pp. 96 ◽  
Author(s):  
GJ Mutze
Keyword(s):  
South Australia ◽  
Cost Effective ◽  
Long Term Effects ◽  
Short Term ◽  
Long Term Effect ◽  
Perennial Shrubs ◽  
Control Work ◽  
Semi Arid

Warren ripping and poisoning were used to control rabbits on the flood-out plain of a major creek system on Manunda Station, a sheep-grazing property near Yunta in semi-arid South Australia. Rabbit numbers were initially reduced by >99 per cent, as indicated by the number of active entrances remaining in rabbit warrens. After nearly 10 years without follow-up control work, ripped warrens had only two per cent of the pre-control number of active entrances. Poisoning effectively reduced rabbit numbers in the short-term, but had no long-term effect on the number of active entrances, either in ripped or unripped warrens. Perennial shrubs regenerated on and around ripped warrens. Warren ripping on this part of Manunda is a cost-effective management option.

Good Safety and Tolerance Profiles of Long Term Treatment of Advanced Multiple Myeloma (MM) with Bortezomib.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4811-4811
Author(s):  
Jean El-Cheikh ◽  
Anne-Marie Stoppa ◽  
Reda Bouabdallah ◽  
Diane Coso ◽  
Jean-Marc Schiano de Collela ◽  
...  
Keyword(s):  
Dose Reduction ◽  
Term Treatment ◽  
Term Therapy ◽  
Cycle Duration ◽  
Disease Response ◽  
Number Of Patients ◽  
Long Term Treatment ◽  
Grade 3

Abstract Bortezomib is a first-in-class proteasome inhibitor approved for the treatment of MM patients who have received at least one prior therapy. Classically, patients receive bortezomib 1.3 or 1.0 mg/m2 by IV bolus on days 1, 4, 8, and 11 of a 21-day cycle, associated or not to dexamethasone, for a total number of 8 cycles. Such administration schema is associated with a remarkable anti-tumor activity and response. However, a significant number of patients who are initially responders to bortezomib, will progress after drug discontinuation, raising the question of long term or maintenance treatment with bortezomib. The objective of this analysis was to evaluate the tolerance and safety profiles of long term treatment with bortezomib in a cohort of 16 patients with relapsed and/or refractory MM treated in a single institution. Eligible patients for this analysis are those who had relapsed MM, and who continued to receive bortezomib (1.3 or 1.0 mg/m2) as a long term therapy beyond the classical 8 cycles. All medical charts were uniformly reviewed in detail for assessment of toxicity, safety and response. The median age was 53 (range, 27–74) years. The majority of patients had already received at least one prior autologous or allogeneic stem cell transplantation (n=12; 75%). Also, 12 patients (75%) had received prior treatment with thalidomide at a median dose of 200 mg/day, for a median duration of 7 months. Before treatment with bortezomib, 7 patients (44%) already had some form of peripheral neuropathy (PN). With a median follow-up of 16 months from bortezomib initiation, patients from this series received a median of 10 (range, 9–16) cycles of bortezomib administered over a median period of 11 (range, 7–35) months. Overall, 6 patients had evidence of bortezomib-associated PN (38%; 4 grade 1, 1 grade 2 and 1 grade 3; sensory symptoms in all cases). Other bortezomib-related toxicities included thromobopenia (n=8; 50%; 1 grade 1, 5 grade 2, and 2 grade 3–4). General fatigue was also common and was encountered in 5 (31%) patients. Overall, bortezomib-associated toxicities led to dose reduction or increase of treatment cycle duration in 9 patients (56%), but none of the patients had to definitively discontinue treatment because of unacceptable toxicity. At last follow-up, 6 patients are still receiving bortezomib, 4 patients died from disease progression, no patient died from treatment-related causes, and the remaining 12 patients are still alive. Long term treatment with bortezomib was associated with an objective disease response rate in 87% (95%CI, 60–98%) of patients (n=14; 3 CR, 8 VGPR, 3 PR). The Kaplan-Meier estimate for overall survival is shown in the figure below. Though relatively small, results from this series suggest that long term treatment with bortezomib is feasible. Toxicity, tolerance and safety profiles of long term treatment are comparable to those observed with the standard schedule and manageable after dose reduction. Therefore, prospective studies aiming to optimize bortezomib administration schedule and duration (beyond the classical 8 cycles) are warranted, since such long term treatment can yield major objective disease response. Figure Figure

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.

scholarly journals Clinical Holistic Medicine (Mindful, Short-Term Psychodynamic Psychotherapy Complemented with Bodywork) in the Treatment of Experienced Impaired Sexual Functioning

2007 ◽  
Vol 7 ◽  
pp. 324-329 ◽  
Author(s):  
Søren Ventegodt ◽  
Suzette Thegler ◽  
Tove Andreasen ◽  
Flemming Struve ◽  
Lars Enevoldsen ◽  
...  
Keyword(s):  
Sexual Functioning ◽  
Psychodynamic Psychotherapy ◽  
Holistic Medicine ◽  
Term Therapy ◽  
Important Goal ◽  
True Self ◽  
Short Term ◽  
The Cost

In this clinical follow-up study, we examined the effect of clinical holistic medicine (psychodynamic short-term therapy complemented with bodywork) on patients with poor self-assessed sexual functioning and found that this problem could be solved in 41.67% of the patients ((95% CI: 27.61–56.7%; 1.75 < NNT < 3.62, p = 0.05). The bodywork was inspired by the Marion Rosen method and helped the patients to confront painful emotions from childhood trauma(s), and thus accelerated and deepened the therapy. The goal of therapy was the healing of the whole life of the patient through Antonovsky-salutogenesis. In this process, rehabilitation of the character and purpose of life of the patient was essential, and assisted the patient to recover his or her sense of coherence (existential coherence). We conclude that clinical holistic medicine is the treatment of choice if the patient is ready to explore and assume responsibility for his or her existence (true self), and willing to struggle emotionally in the therapy to reach this important goal. When the patient heals existentially, quality of life, health, and ability to function in general are improved at the same time. The therapy was “mindful” in its focus on existential and spiritual issues. The patients received in average 14.8 sessions at the cost of 1,188 EURO.

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.

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