Patients
Patient recruitment
A total of 367 outpatients were recruited from psychiatric services in the Helsinki region from June 1994 to June 2000: About 50% of the patients came from psychiatrists working in private practice (29%) or the community mental health care (20%). Other referrals included those from the psychiatric services of student health care (20%), primary health care (16%), and occupational health care (10%).
Choice of patients
Eligible patients were 20-45 years of age and had a long-standing (> 1 year) disorder causing social dysfunction in work ability. They had to meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria (American Psychiatric Association 1994) for an anxiety or depressive disorder and be estimated on a psychodynamic scale of suffering from neurosis to high-level borderline disorder.
Patients were excluded from the study for the following reasons: psychotic disorder or severe personality disorder, bipolar I disorder, adjustment disorder, substance abuse, organic brain disease or other severe organic disease, and mental retardation. Individuals treated with psychotherapy within the previous 2 years, psychiatric health employees, and persons known to the research team members were also excluded.
The patients' profile
The patients were mainly women (75%). 52% of the patients lived alone, 28% had an academic degree, and 68% were working or studying. The majority of patients (86%) suffered from mood disorder. Only 35% had received previous psychiatric care: 20% psychotherapy, 20% psychiatric medication and 2% hospital treatment.