Psychological predictors of the recovery from mood or anxiety disorder in short-term and long-term psychotherapy during a 3-year follow-up

Abstract

Choice of optimal treatment length for psychiatric patients requires knowledge about the patients' pre-treatment suitability. This study compares the prediction of seven psychological suitability measures on changes in psychiatric symptoms in short- and long-term psychotherapy over a 3-year follow-up. The psychological suitability of 326 outpatients from the Helsinki Psychotherapy Study, aged 20-46 years, and suffering from mood or anxiety disorders, was assessed at baseline using the Suitability for Psychotherapy Scale (SPS) before randomly assigning them to solution-focused therapy, short-term or long-term psychodynamic psychotherapy. Psychiatric symptoms (Symptom Checklist-90 Global Severity Index) were assessed at baseline and seven times during follow-up. Three patient groups with different prognosis were found when a cumulative SPS score, summing up the values of the seven single suitability measures, was used to predict symptom development: patients with more good (4 or more) than poor values benefited more from short-term therapy, patients with more poor (4-6) than good values benefited more from long-term therapy, and patients with all seven values poor failed to benefit from either short- or long-term therapy. The SPS can apparently be applied before the start of treatment to predict the amount of therapy patients need to recover, although its suitability in therapies of different types needs to be confirmed.