Use of auxiliary psychiatric treatment during a 5-year follow-up among patients receiving short- or long-term psychotherapy

• Published in: Journal of affective disorders Vol. 135; no. 1; pp. 221 - 230
• Main Authors: Knekt, Paul, Lindfors, Olavi, Renlund, Camilla, Sares-Jäske, Laura, Laaksonen, Maarit A, Virtala, Esa
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01-12-2011; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Auxiliary treatment; Biological and medical sciences; Endpoint Determination; Female; First year; Follow-up; Follow-Up Studies; Hospitalization; Humans; Medical sciences; Middle Aged; Mood disorders; Mood Disorders - therapy; Psychiatry; Psychoanalysis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; Psychotherapy - methods; Psychotherapy, Brief - methods; Psychotherapy, Group; Psychotropic drugs; Psychotropic medication; Short term; Treatment needs; Treatment Outcome; Trial; Young Adult; Psychotropic medication; Psychotherapy; Auxiliary treatment; Hospitalization; Trial; Follow-up; Short term; Human; Psychotropic; Long term; Treatment; Follow up study; Mental disorder
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2011.07.024

Abstract Background The need for treatment is, despite of its obvious usefulness, a scarcely used measure of effectiveness in psychotherapy trials. This study considers changes in the need for auxiliary psychiatric treatment after starting short- and long-term psychotherapy and psychoanalysis. Methods Altogether 326 psychiatric outpatients with mood or anxiety disorder were randomly assigned to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP), or long-term psychodynamic psychotherapy (LPP) while 41 self-selected patients were allocated to psychoanalysis (PA). The patients were followed for 5 years from start of treatment. Outcome measures were use of auxiliary psychotherapy, psychotropic medication, and hospitalization for mental reasons. Results About 60% of the patients used auxiliary treatment during the follow-up. It was most common in the short-term therapy groups and its incidence was highest during the first year after the start of therapy. The average numbers of all therapy sessions among patients starting the therapy were 60, 70, 240, and 670 in SFT, SPP, LPP, and PA, respectively, whereas the corresponding average numbers of study therapy sessions alone were 10, 19, 232, and 646. Over 50% of the patients receiving short-term therapy received on average 4–6 times more therapy sessions than initially assigned. Limitations Post-randomization withdrawal was uneven. Conclusions Auxiliary treatment is usual among patients receiving short- and long-term therapies, and apparently becomes common shortly after the start of treatment. Auxiliary treatment can be used as an outcome measure indicating the need for treatment, should be monitored clinically and considered when interpreting the results of effectiveness studies.