P0215 - The effectiveness of psychoanalysis and long- and short-term psychotherapy on psychiatric symptoms during a 5-year follow-up; A quasi-experimental study

Abstract

The Helsinki Psychotherapy Study (HPTP) showed that short-term or long-term psychotherapy are insufficient treatments for part of the patients with depressive or anxiety disorder. Psychoanalysis might help such patients, but the empirical evidence is scarce. This quasi-experimental study compares the effectiveness of two short-term psychotherapies and one long-term psychotherapy with that of psychoanalysis in the treatment of depressive and anxiety disorders. A total of 326 psychiatric outpatients from the Helsinki area, with depressive or anxiety disorder, were randomly assigned to solution-focused therapy or to short-term or long-term psychodynamic psychotherapy. Furthermore, 41 patients suitable for psychoanalysis were included. The patients were followed for 5 years from start of therapy. Primary outcome measures were depressive symptoms, measured by the self-report Beck Depression Inventory (BDI) and the observer-related Hamilton Depression Rating Scale (HDRS), and anxiety symptoms measured by the self-report Symptom Check List, Anxiety scale (SCL-90-Anx) and the observer-related Hamilton Anxiety Rating Scale (HARS). The statistical analyses were based on an ’Intention-to-treat’ –design. A significant reduction of symptoms was noted in all treatment groups during the follow-up. Recovery was fastest in both short-term therapy groups and slowest in the psychoanalysis group. After 5 years of follow-up, however, psychoanalysis was the most effective. About 82% of the patients receiving psychoanalysis recovered from their symptoms (BDI < 10), whereas the corresponding proportion for the other groups varied from 48-67%. In the long run psychoanalysis might be more effective than long-term or short-term therapies. The results are, however, preliminary and no firm conclusions can be drawn.