MedWire News: Short-term psychodynamic psychotherapy produces benefits in patients with psychiatric symptoms more quickly than long-term therapy, but long-term therapy is more beneficial in the longer term, Finnish study findings suggest.
Mood and anxiety disorders commonly have a recurrent and chronic course. Although there are a range of short- and long-term psychotherapies for such conditions, there is a lack of evidence as to which offer the best outcomes, say Paul Knekt, from the National Public Health Institute in Helsinki, and colleagues.
To investigate, the team studied 326 outpatients, of whom 84.7% had mood disorders and 43.6% anxiety disorder. The patients were assigned to long-term psychodynamic psychotherapy, short-term psychodynamic psychotherapy, or solution-based therapy, and followed-up for 3 years.
The self-report Beck Depression Inventory (BDI) and Symptom Check List Anxiety Scale (SCL-90-Anx) were administered at baseline and at 3, 7, 9, 12, 24, and 36 months' follow-up, and the observer-rated Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) at baseline and at 7, 12, and 36 months' follow-up.
In all, 128 patients were assigned to long-term psychodynamic therapy, 101 to short-term psychodynamic therapy, and 96 to solution-based therapy, with 42 discontinuing treatment prematurely. Approximately 60% of participants used auxiliary treatment and 3.1% were admitted to hospital, none of whom were assigned to solution-based therapy.
The results revealed statistically significant reductions in symptoms on all rating scales, at 51% on the BDI, 36% on the HAM-D, 41% on the SCL-90-Anx, and 38% on the HAM-A.
During the first year, short-term psychodynamic therapies were significantly more effective than long-term psychodynamic therapy, with comparative reductions on the four scales of 15-27%. There were no significant differences during the second year, while long-term psychodynamic therapy was more effective after 3 years' follow-up, with comparative reductions of 14-37% on the outcome measures.
There were no significant differences between short-term psychodynamic therapy and solution-based therapy at any of the follow-up assessments, the researchers reports in the journal Psychological Medicine.
They conclude: "The findings indicate that the length of therapy rather than the form is important when predicting the outcome of the therapy. More research comparing the effects of different forms of short-term and long-term therapies is needed, however."
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