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.

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.

Personality Inventory Correlates of Outcome in a Follow-up Study of Psychiatric Hospitalization

1980 ◽  
Vol 46 (3) ◽  
pp. 903-906 ◽  
Author(s):  
Rhodes C. Young ◽  
Edward Gould ◽  
Ira D. Glick ◽  
William Hargreaves
Keyword(s):  
Rating Scale ◽  
Psychiatric Hospitalization ◽  
Self Report ◽  
Psychiatric Evaluation ◽  
Short Term ◽  
Follow Up Study ◽  
Report Data ◽  
Self Report Data

The study involved a comparison of two diagnostic groups, schizophrenic and nonschizophrenic, randomly assigned to short-term hospitalization (defined as 3 to 4 wk.) versus long-term hospitalization (defined as 3 to 4 mo.). Outcome indices were derived separately from the Health-Sickness Rating Scale and the Psychiatric Evaluation Form, based on ratings at admission, at discharge, and 1 and 2 yr. post-admission. Scores from the intake administration of the MMPI were predictive of outcome for the 26 long-term nonschizophrenics but not for the other groups. To understand the variability in predictive efficacy, all of the self-report data were analyzed for dependability by application of the Wald-Wolfowitz Runs test to the MMPI answer sequences. No response inter-dependency among the total group of 47 nonschizophrenics was noted, but a significant amount was among the combined group of 86 schizophrenics. For the schizophrenics apparently unreliability of response had reduced the potential for prediction from the MMPI.

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.

scholarly journals The role of long-term psychodynamic psychotherapy in improving attachment patterns, defense styles, and alexithymia in patients with depressive/anxiety disorders

2019 ◽  
Vol 41 (1) ◽  
pp. 43-50
Author(s):  
Mojgan Khademi ◽  
Mahmoud Hajiahmadi ◽  
Mahbobeh Faramarzi
Keyword(s):  
Anxiety Disorders ◽  
Attachment Styles ◽  
Psychodynamic Psychotherapy ◽  
Depressive Disorders ◽  
Self Psychology ◽  
Post Treatment ◽  
Defense Styles ◽  
The Mean

Abstract Introduction Long-term psychodynamic psychotherapy (LTPP) emphasizes the centrality of intrapsychic and unconscious conflicts and their relation to development. Although there is evidence supporting the efficacy of LTPP in mental disorders, little research has been published on the efficacy of LTPP for depressive and anxiety disorders. Objective To examine whether patients with anxiety and depressive disorders demonstrate improvement in their attachment styles, defense styles, psychiatric symptoms, anxiety/depressive symptoms, and alexithymia with LTPP. Methods In this retrospective, descriptive study, the psychological outcomes of patients who were treated at the psychoanalytic clinic of Babol University of Medical Sciences were assessed. Fourteen patients diagnosed with depressive or anxiety disorder participated in the study of LTPP using the self-psychology approach. The Beck Depression Inventory II, Beck Anxiety Inventory, Adult Attachment Scale, 40-item Defense Style Questionnaire, and the 20-item Toronto Alexithymia Scale were administered at pre-treatment, post-treatment, and 6-month follow-up. Generalized estimating equations were used to analyze changes in psychological outcomes after each of the three assessments. Results The mean scores of depression and anxiety and secure attachment improved significantly after LTPP with self-psychology approach from baseline to post-treatment and follow-up. Also, the mean scores of neurotic and immature defenses, difficulty in identifying feelings, difficulty in describing feelings, externally oriented thinking, and total alexithymia scores decreased significantly from baseline to post-treatment and follow-up. Conclusion Symptoms of anxiety disorders, depressive disorders, insecure attachment styles, alexithymia, and neurotic/immature defense styles improved after the LTPP with self-psychology approach. Moreover, the improvements persisted at the 6-month follow-up.

scholarly journals Long-term effectiveness and prediction of treatment outcome in cognitive behavioral therapy and sertraline for late-life anxiety disorders

2009 ◽  
Vol 21 (6) ◽  
pp. 1148-1159 ◽  
Author(s):  
Josien Schuurmans ◽  
Hannie Comijs ◽  
Paul M. G. Emmelkamp ◽  
Ingrid J. C. Weijnen ◽  
Marcel van den Hout ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Anxiety Disorders ◽  
Behavioral Therapy ◽  
Late Life ◽  
Term Treatment ◽  
Short Term ◽  
Long Term Treatment ◽  
One Year

ABSTRACTBackground: Although anxiety disorders are prevalent in older adults, randomized controlled trials of treatment effectiveness for late-life anxiety are scarce and have focused primarily on the effectiveness of psychotherapeutic interventions. However, recent findings suggest that in some cases, pharmacological treatment may be more beneficial for late-life anxiety disorders. As yet, there have been no systematic studies investigating prognostic factors for the outcome of cognitive behavioral therapy (CBT) and pharmacotherapy for late-life anxiety. The objective of the present study was to study long-term treatment outcomes and to explore differential predictors for both short-term and long-term treatment outcomes of sertraline and CBT for late-life anxiety disorders.Methods: Participants of a randomized controlled trial (RCT) comparing sertraline and CBT for the treatment of late-life anxiety were contacted one year after completing their treatment, so that predictors for both short-term and long-term treatment outcome could be established.Results: Sertraline showed a greater reduction of symptoms than CBT on anxiety (Hamilton Anxiety Rating Scale; HARS) and worry (Worry Domain Questionnaire) ratings at one-year follow-up. The strongest predictor for short-term CBT outcome was poor perceived health, explaining 40% of the variance in post-treatment residual gain scores on the HARS. The strongest predictor for long-term CBT outcome was neuroticism, explaining 20% of the variance in residual gain scores at one-year follow-up. Analyses revealed no significant predictors for treatment outcome in sertraline participants.Conclusions: Our study suggests that long-term use of sertraline might be more beneficial for late-life anxiety than a 15-week CBT program. Poor perceived health and neuroticism are predictive of less improvement after CBT in anxious older adults. Implications of these findings are discussed.

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.

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