Cost-effectiveness of therapies of different mode and length
Maljanen, T., Paltta, P., Härkänen, T., Virtala, E., Lindfors, O., Laaksonen, M., . . . the Helsinki Psychotherapy Study Group. (2012). The cost-effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorders during a 1-year follow-up. Journal of Mental Health Policy and Economy, 15, 3-13.
Maljanen, T., Tillman, P., Härkänen, T., Virtala, E., Lindfors, O., Knekt, P., & the Helsinki Psychotherapy Study Group. (2014). The cost-effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorders during a three-year follow-up. Open Journal of Psychiatry, 4, 238-250.
The aims of this ongoing study are to evaluate the cost-effectiveness of two short-term and two long-term psychotherapies (Knekt et al. 2012). The study is based on the data of 367 psychiatric outpatients, participants of the Helsinki Psychotherapy Study, having long-standing depressive or anxiety disorder causing work dysfunction. Patients with psychotic disorder, severe personality disorder, adjustment disorder, bipolar disorder or substance abuse were excluded. Solution-focused therapy included 12 and short-term psychodynamic psychotherapy 20 therapy sessions, both therapies lasting about half a year. The long-term therapies were open-ended, psychodynamic psychotherapy lasting about 3years with about 240 sessions and psychoanalysis lasting about 5 years with about 650 sessions. All the therapists had received standard training and were experienced. Both direct costs (therapy sessions, outpatient visits, medication, inpatient care) and indirect costs (production losses due to work absenteeism, value of neglected household work, lost leisure time and unpaid help received) due to the treatment of psychiatric problems were estimated, prior to start of treatment and at 14 pre-chosen time points during a 10-follow-up from start of treatment. Likewise, the assessment of effectiveness was based on repeated measurement of psychiatric symptoms and recovery, need for treatment, and work ability. Incremental cost-effectiveness will be estimated.
Original contributions (Maljanen et al. 2012, 2014) have been published from this sub-study and are ongoing (see cited literature above and our homepage).
This cost-effectiveness study, with an exceptionally long- follow-up, will provide information for evaluating the economic and health-related benefits of different short-term and long-term psychotherapies. The study may have implications for the allocation of health-care resources.
Dr. Paul Knekt
National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki