Sociodemographic Factors as Predictors of the Duration of Long-term Psychotherapy: Evidence from a Finnish Nationwide Register Study

Abstract

Objective: The role of sociodemographic factors in determining psychotherapy duration has been largely unexplored despite their known association with treatment use. We examined the association between sociodemographic factors and rehabilitative psychotherapy treatment duration, as well as any changes in duration over time. Method: We used three register-based nationally representative cohorts. Participants included employed Finnish individuals (n = 5572, 77% women, mean age = 37) who started psychotherapy treatment in 2011, 2013 or 2016 and were followed until 2019. We used negative binomial regression to examine the association between sociodemographic factors (age, gender, education, occupational status, income, geographical area of residence, and onset year of treatment) with treatment duration. Results: The mean treatment duration was 27 months (with a standard deviation of 12 months). Several sociodemographic factors were associated with treatment duration. Gender and education were found to have the largest impact on treatment duration, with females having a longer duration (IRR 1.08, 95% CI 1.04–1.11) and those with low education having a shorter duration (IRR 0.91, 95% CI 0.85–0.97), resulting in a difference of 2–3 months. Treatment duration also increased in later years, which suggests potentially increasing differences in treatment implementation. At largest, the combined effect of all factors corresponded to a 10-month difference in treatment duration. Conclusions: The duration of long-term psychotherapy varied across the sociodemographic groups and increased in all studied groups in the 2010s.