Long-term psychotherapy superior in treating chronic mental disorders

Oct 1 2008

German researchers say they have found that long-term psychotherapy is effective and even superior to shorter-term therapy for patients with complex mental disorders such as personality and chronic mental disorders.

In long-term psychotherapy the emphasis is placed on more interpretive or supportive interventions, depending on the patient's needs, and that involves careful attention to the therapist-patient interaction.

The results of their study involving more than 1,000 patients provides rare evidence that this type of treatment works - previous research has suggested that short-term psychodynamic psychotherapy is insufficient for a considerable proportion of patients with complex mental disorders.

The researchers from University of Giessen analysed data from 23 medical studies involving patients with complex mental disorders and they found that those who received long-term treatment did far better.

Dr. Falk Leichsenring one of the lead researchers says there is evidence that for patients with chronic mental disorders or personality disorders, short-term psychotherapy is not sufficient but long-term psychodynamic psychotherapy showed significant, large and stable treatment effects, which significantly increased between end of treatment and follow-up assessment.

The researchers found patients with significant mental health issues who received therapy for at least a year were better off than 96% of the patients undergoing shorter-term treatment.

The researchers say long-term psychoanalysis remains controversial because there is so little evidence showing its effectiveness, and insurance companies are loath to pay for treatments that lack hard data showing they work, but Dr. Leichsenring says not only is it effective - it also seems to be cost effective.

Experts say medications, whatever the condition, have limited effects and experience shows people benefit from longer term treatment in which they are able to deepen the coping skills they develop in psychotherapy.

They say the research comes at a time when the provision of psychotherapy by psychiatrists in the United States is declining significantly which appears to be "strongly related to financial incentives and other pressures to minimize costs."

The research appears in the Journal of the American Medical Association.