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Introduction
Mood and anxiety disorders are prevalent and incapacitating disorders that commonly run a recurrent and chronic course (WHO, 2000). Different psychotherapies, short and long, are widely applied in the treatment of these disorders, and therefore their effectiveness is an important issue. Clinical trials have demonstrated that short-term psychodynamic psychotherapy, which is a brief, focused and active treatment, is effective in the treatment of mood and anxiety disorders (Anderson & Lambert, 1995; Barber & Ellman, 1996). Long-term psychodynamic psychotherapy, which is a more intensive approach than short-term psychodynamic psychotherapy, is widely used in ordinary clinical practice. The evidence on the effectiveness of long-term psychodynamic psychotherapy is, however, limited and entirely based on non-randomized studies (Piper et al. 1984; Wilczek et al. 2004; Bond & Perry, 2006). Solution-focused therapy, which is a brief goal-focused treatment developed from therapies applying a problem-solving approach and systemic family therapy (Gingerich & Eisengart, 2000), has been reported to produce rapid effects with reductions in psychiatric symptoms after only a few sessions (Lambert et al. 1998).
Short-term psychodynamic psychotherapy has, with some exceptions (Svartberg & Stiles, 1991), been found to be equally effective as other short-term individual treatments, such as cognitive (Crits-Christoph, 1992; Anderson & Lambert, 1995; Leichsenring, 2001; Wampold et al. 2002; Leichsenring et al. 2004), interpersonal (Crits-Christoph, 1992), supportive therapy (Anderson & Lambert, 1995; Leichsenring et al. 2004) and solution-focused therapy (Knekt & Lindfors, 2004). The effects of short-term psychodynamic psychotherapy have also been shown to be stable or even to increase during follow-up (Leichsenring et al. 2004). Since the follow-up times in trials published so far have been relatively short, the maintenance of treatment effect in different brief individual psychotherapies in the long run is an issue which remains unanswered. So far, no evidence from randomized clinical trials exists on the differential effectiveness of short- and long-term therapies.
To address the lack of evidence concerning the effectiveness of long-term psychodynamic psychotherapy and the stability of the treatment effects of short-term therapies we conducted a randomized clinical trial comparing the effectiveness of long- and short-term psychodynamic psychotherapy as well as psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorders during a 3-year follow-up from the start of therapy.
Patients and method
The methods used have...