OBJECTIVES: Different types of psychotherapy, alone or together with pharmaceuticals, are used extensively in the treatment of depressive and anxiety disorders. However, only a few studies thus far have addressed the cost-utility of different psychotherapies. The aim of this study is to compare the direct health care costs and the quality of life of persons who have suffered from depression or anxiety and have been treated either with short-term psychodynamic psychotherapy (SPP) or solution-focused therapy (SFT). The follow-up period was three years. METHODS: A total of 198 outpatients aged 20–45 years suffering from mood or anxiety disorder were randomized to SPP or SFT. Patients’ quality of life was assessed using Chubon’s Life Situation Survey (LSS). The assessments took place at baseline and at 7, 12 and 36 months after the start of the therapy. All direct costs due to mental health problems incurred during the three-year follow-up period were taken into account in the analysis.  RESULTS: During the first 7 months patients’ quality of life improved considerably, with mean LSS scores increasing from about 79 to about 93 in both groups. This change was also statistically significant. After the 7th month some minor improvements continued to be observed in quality of life. At the end of the follow-up period the mean LSS scores were in both groups somewhat below 100, a threshold for very good life quality. The differences between the two groups were very small at every measurement point and not statistically significant. The direct costs were about equal in both groups. The small positive changes observed in the quality of life after the 7th month were at least partly due to auxiliary treatments whose costs were much higher than the costs of SPP or SFT. CONCLUSIONS: There is little appreciable difference in cost-utility between SPP and SFT.