Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during 3-year follow-up
Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during 3-year follow-up
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DOI：
10.1017/s003329170700164x
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发表时间：
2008-05-01
影响因子：
6.9
通讯作者：
Renlund, C.
中科院分区：
文献类型：
--
作者：
Knekt, P.;Lindfors, O.;Renlund, C.
背景没有足够的证据表明，在治疗精神疾病的长期和短期心理疗法之间存在可行的选择。本试验比较了一种长期疗法和两种短期疗法治疗情绪和焦虑障碍的有效性。在赫尔辛基心理治疗研究中，326名患有情绪（84.7%）或焦虑症（43.6%）的门诊患者被随机分配到三个治疗组（长期心理动力学心理治疗，短期心理动力学心理治疗和解决方案集中治疗），并从治疗开始随访3年。采用Beck抑郁量表（BDI）和汉密尔顿抑郁量表（HAMD）评定抑郁症状，采用焦虑症状自评量表（SCL-90-Anx）和汉密尔顿焦虑量表（HAMA）评定焦虑症状。在3年的随访中，BDI（51%）、HAMD（36%）、SCL-90-Anx（41%）和HAMA（38%）的症状显著减轻。在第一年，短期心理动力学心理治疗比长期心理动力学心理治疗更有效，四项结果测量的得分低15-27%。在第二年的随访中，短期和长期治疗之间没有显着差异，3年随访后，长期心理动力学心理治疗更有效，结果变量评分降低14-37%。短期治疗的有效性无统计学显著差异。短期治疗比长期心理动力学心理治疗更快地产生效益，但从长远来看，长期心理动力学心理治疗上级短期治疗。然而，需要更多的研究来确定哪些患者应该接受长期心理治疗来治疗情绪或焦虑症。
Background. Insufficient evidence exists for a viable choice between long- and short-term psychotherapies in the treatment of psychiatric disorders. The present trial compares the effectiveness of one long-term therapy and two short-term therapies in the treatment of mood and anxiety disorders.Method. In the Helsinki Psychotherapy Study, 326 out-patients with mood (84.7%) or anxiety disorder (43.6%) were randomly assigned to three treatment groups (long-term psychodynamic psychotherapy, short-term psychodynamic psychotherapy, and solution-focused therapy) and were followed up for 3 years from start of treatment. Primary outcome measures were depressive symptoms measured by self-report Beck Depression Inventory (BDI) and observer-rated Hamilton Depression Rating Scale (HAMD), and anxiety symptoms measured by self-report Symptom Check List Anxiety Scale (SCL-90-Anx) and observer-rated Hamilton Anxiety Rating Scale (HAMA).Results. A statistically significant reduction of symptoms was noted for BDI (51%), HAMD (36%), SCL-90-Anx (41%) and HAMA (38%) during the 3-year follow-up. Short-term psychodynamic psychotherapy was more effective than long-term psychodynamic psychotherapy during the first year, showing 15-27% lower scores for the four outcome measures. During the second year of follow-up no significant differences were found between the short-term and long-term therapies, and after 3 years of follow-up long-term psychodynamic psychotherapy was more effective with 14-37% lower scores for the outcome variables. No statistically significant differences were found in the effectiveness of the short-term therapies.Conclusions. Short-term therapies produce benefits more quickly than long-term psychodynamic psychotherapy but in the long run long-term psychodynamic psychotherapy is superior to short-term therapies. However, more research is needed to determine which patients should be given long-term psychotherapy for the treatment of mood or anxiety disorders.