Abstract
Knekt P and Lindfors O (eds.) A randomized trial of the effect of four forms of psychotherapy on depressive and anxiety disorders: Design, methods, and results on the effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy during a one-year follow-up. Helsinki: The Social Insurance Institution, Finland. Studies in Social Security and Health 77, 2004, 112 pp. ISBN 951-669-639-2.
The Helsinki Psychotherapy Study (HPS) is a randomized clinical trial comparing the effectiveness of four forms of psychotherapy in the treatment of depressive and anxiety disorders. A total of 367 Finnish psychiatric outpatients from the Helsinki region, 20-46 years of age and suffering from depressive or anxiety disorders, were recruited for the study in 1994-2000. A total of 326 patients were randomly assigned to one of 3 treatment groups: solution-focused therapy, short-term psychodynamic psychotherapy, and long-term psychodynamic psychotherapy. The patients assigned to the long-term psychodynamic psychotherapy group and 41 patients self-selected for psychoanalysis were included in a quasi-experimental design. The primary outcome measures were depressive and anxiety symptoms, while secondary measures included work ability, need for treatment, personality functions, social functioning, and life style. Cost-effectiveness was determined. The data were collected from interviews, questionnaires, psychological tests, and public health registers. The outcome measures were assessed up to 9 times during a 5-year follow-up. Patients on short-term psychodynamic psychotherapy and solution-focused therapy showed considerable decline in depressive and anxiety symptoms during the first year of follow-up, whereas work ability, personality functions, and social functioning were only slightly improved. The result did not differ between the 2 forms of therapy; both types are thus effective in the treatment of depressive and anxiety disorders but for the majority of patients they are not sufficient in producing recovery. Longer follow-ups are needed to evaluate the duration of treatment effects in the 2 groups. The HPS is one of the largest clinical trials on the effect of psychotherapy in the treatment of depressive and anxiety disorders. The results are likely to be incorporated into clinical practice and to impact public health.