OBJECTIVES: The short- and long-term effects of open-ended, long-term psychoanalytic psychotherapy for young adults were investigated. Possible changes during the year and a half follow-up, as well as predictors of change, were explored.

DESIGN: Patients aged 18-25 years who accepted the offered psychoanalytic individual or group psychotherapy were included. Patients filled out questionnaires and were interviewed at intake, termination, and follow-up. Alliance data were collected after the second session of psychotherapy proper.

METHODS: The primary outcome measures were the Symptom Checklist-90 and the Inventory of Interpersonal Problems. The Helping Alliance Questionnaire-II was used to measure alliance. Mixed model ANOVAs were used to analyse changeover time and prediction of change in relation to gender, treatment format, treatment duration, and in individual psychotherapy, therapist- and patient-rated alliance.

RESULTS: All outcome measures changed significantly from intake to follow-up. None changed significantly during the follow-up period, but there was a tendency towards recurring symptoms and an improvement in one of the object relational measures during the follow-up. The latter was the only outcome measure that did not change significantly during treatment. Lower therapist-rated alliance was predictive of greater change in psychiatric symptoms for patients with high levels of symptoms at intake.

CONCLUSIONS: The long-term effectiveness of psychoanalytic psychotherapy for young adults was supported. Low therapist-rated alliance implies that the therapists have identified problematic interactions, which might have mobilized their effort to solve the problems. Further research on cases reporting no gain or even deterioration is needed.