Patients

Patient recruitment

A total of 506 outpatients were recruited from psychiatric services in the Helsinki region from June 1994 to June 2000. About half of the patients came from psychiatrists working in private practice (29 %) or the community mental health care (20 %). Other referrals included those from the psychiatric services of student health care (20 %), primary health care (16 %), and occupational health care (10 %).

Choice of patients

Eligible patients were 20-45 years of age and had a long-standing (> 1 year) disorder causing social dysfunction in work ability. They had to meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria (American Psychiatric Association 1994) for an anxiety or depressive disorder and be estimated on a psychodynamic scale of suffering from neurosis to high-level borderline disorder.

Patients were excluded from the study for the following reasons: psychotic disorder or severe personality disorder, bipolar I disorder, adjustment disorder, substance abuse, organic brain disease or other severe organic disease, and mental retardation. Individuals treated with psychotherapy within the previous 2 years, psychiatric health employees, and persons known to the research team members were also excluded.

Of the 506 patients referred, 139 refused to participate, and the remaining 367 patients were assigned to study treatments.

The patients' profile

The patients were mainly women (75 %). 52 % of the patients lived alone, 28 % had an academic education, and 68% were working or studying. The majority of patients (86 %) suffered from mood disorder. Only 35 % had received previous psychiatric care: 20 % psychotherapy, 20 % psychotropic medication and 2 % hospital treatment.