Adverse events during a disorder‐specific psychotherapy compared to a nonspecific psychotherapy in patients with chronic depression

Meister, Richard; Lanio, Jana; Fangmeier, Thomas; Härter, Martin; Schramm, Elisabeth; Zobel, Ingo; Hautzinger, Martin; Nestoriuc, Yvonne; Kriston, Levente

doi:10.1002/jclp.22869

Cited by 19 publications

(20 citation statements)

References 27 publications

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“…In general, adverse event methods seem to be heterogeneous and insufficiently reported in RCTs in CD ( 49 ). However, a recent study found that patients receiving supportive psychotherapy reported less severe adverse events in general and less severe adverse events related to personal life and to occupational life than patients receiving CBASP, while less adverse events related to suicidal thoughts were reported in CBASP compared with supportive psychotherapy ( 50 ). The authors discussed that the differences in the profile of adverse events may be explained by specific treatment elements, as adverse events related to personal and professional life, for example, may be considered a necessary and expected but temporary adverse treatment outcome of effective CBASP treatment.…”

Section: Discussionmentioning

confidence: 99%

Negative Effects of a Multimodal Inpatient CBASP Program: Rate of Occurrence and Their Impact on Treatment Outcome in Chronic and Treatment-Resistant Depression

et al. 2021

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Background: A growing number of studies indicate that the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is effective in treating chronic depression. However, there is no systematic research into possible negative effects. Therefore, the objectives of the study were to investigate the rate of occurrence of negative effects of an inpatient CBASP program and their impact on treatment response.Methods: Patients with chronic depression and treatment resistance who completed the 12-week multimodal inpatient CBASP treatment program in an open trial (N = 52) retrospectively completed the Inventory for the Assessment of Negative Effects of Psychotherapy (INEP) during follow-up data collection. Severity of depressive symptoms was assessed self- and observer-rated at admission, discharge, and 6 months follow-up. Rates of occurrence of negative effects were calculated and binary logistic regression analyses were conducted to determine the relationship to treatment outcome.Results: The results indicate that 92.3% of patients reported having experienced at least one negative effect and 45.2% indicated dependence on their therapist. Stigmatization and financial concerns as well as intrapersonal changes were reported by about one-third. Only dependence on the therapist negatively impacted treatment outcome in both outcome measures.Conclusions: While almost all patients reported at least one negative effect of a multimodal inpatient CBASP treatment program, most of the reported negative effects appear to be benign. However, dependence on the therapist seems to have a negative impact on treatment outcome. If these results can be replicated in future large-scale, randomized controlled prospective studies, CBASP therapists should be aware of possible dependence and consciously address it during treatment.

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Section: Discussionmentioning

confidence: 99%

Negative Effects of a Multimodal Inpatient CBASP Program: Rate of Occurrence and Their Impact on Treatment Outcome in Chronic and Treatment-Resistant Depression

et al. 2021

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“…net/ 1-glossary). Our semi-structured interview is an improvement on current GCP procedures in that most clinical trials assess the SAE variable based on patients spontaneous reports (for an example in psychotherapy research, see Meister et al 45 ). However, the SAE assessment has not been psychometrically validated yet.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Effectiveness and safety of the adjunctive use of an internet-based self-management intervention for borderline personality disorder in addition to care as usual: results from a randomised controlled trial

et al. 2021

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ImportanceBorderline personality disorder (BPD) is a severe mental disorder that is often inadequately treated.ObjectiveTo determine if adding a self-management intervention to care as usual (CAU) is effective and safe.DesignRandomised, controlled, rater-blind trial. Duration of treatment and assessments: 12 months.SettingSecondary care, recruited mainly via the internet.ParticipantsPatients with BPD and BPD Severity Index (BPDSI) of at least 15.InterventionsCAU by treating psychiatrist and/or psychotherapist alone or adjunctive use of an internet-based self-management intervention that is based on schema therapy (priovi).Main outcome measureOutcomes were assessed by trained raters. The primary outcome was change in BPDSI. The safety outcome was the number of serious adverse events (SAEs). The primary outcome time point was 12 months after randomisation.ResultsOf 383 participants assessed for eligibility, 204 were included (91.7% female, mean age: 32.4 years; 74% were in psychotherapy and 26% were in psychiatric treatment). The slope of BPDSI change did not differ significantly between groups from baseline to 12 months (F3,248= 1.857, p=0.14). At 12 months, the within-group effect sizes were d=1.38 (95% CI 1.07 to 1.68) for the intervention group and d=1.02 (95% CI 0.73 to 1.31) for the control group. The between-group effect size was d=0.27 (95% CI 0.00 to 0.55) in the intention-to-treat sample and d=0.39 (95% CI 0.09 to 0.68) for those who used the intervention for at least 3 hours (per-protocol sample). We found no significant differences in SAEs.ConclusionsWe have not found a significant effect in favour of the intervention. This might be due to the unexpectedly large effect in the group receiving CAU by a psychiatrist and/or psychotherapist alone.Trial registrationNCT03418142.

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“…Second, the e cacy of psychological counselling depends on the clinical communication and utilization of hybrid skills of the practicing psychologists [14][15][16]. Third, few studies have described any adverse event data of psychological counselling, although the dropout rate is known to be high according to previous research [17,18]. Therefore, an understanding of cancer patients' needs around counselling is still needed to provide a more effective treatment method for their psychological distress.…”

Section: Introductionmentioning

confidence: 99%

Cancer Patients’ Preferences for Psychological Counselling: A Cross-Sectional Study Using Full-Profile Conjoint Analysis in Japan

Ichikura

Sayuri

Oshima

et al. 2021

Preprint

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Background: Psychological counselling is an effective non-pharmacological intervention for cancer patients facing psychological distress. However, there are barriers to applying counselling in clinical settings because some cancer patients feel that it is a burden and subsequently drop out. This study assessed cancer patients’ preferences for psychological counselling using a conjoint analysis approach.Methods: We conducted a single-center, cross-sectional study using a self-reported questionnaire. The data were collected from outpatients and inpatients at the departments of Respiratory Medicine, Gastrointestinal Surgery, Female Pelvic Surgery, and Head and Neck Surgery from a university hospital between March 2018 and March 2020. The questionnaire, developed from an interview with a clinical psychologist, asked for patients’ preferences for counselling with 48 scenarios according to a combination of type, length, price, and frequency. We conducted a conjoint analysis, calculating the relative importance and part-worth value of each factor.Results: According to the conjoint analysis modeling, cancer patients consider the type as the most important factor when deciding whether to undergo counselling (relative importance: 37.5%), followed by frequency (23.4%), price (19.6%), and length (19.5%). Cancer patients value life reviews highly among the four counselling types. However, women and younger patients valued counselling for emotional control the highest, with advanced cancer patients valuing counselling for problem solving the most.Conclusions: The results reveal that cancer patients consider the type and content of counselling to be the most important factors in the selection process, although preferences depend on individual characteristics. This is the first study to clarify cancer patients’ preferences for psychological counselling using conjoint analysis and proposes a new economical method in the psycho-oncology field.

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Adverse events during a disorder‐specific psychotherapy compared to a nonspecific psychotherapy in patients with chronic depression

Cited by 19 publications

References 27 publications

Negative Effects of a Multimodal Inpatient CBASP Program: Rate of Occurrence and Their Impact on Treatment Outcome in Chronic and Treatment-Resistant Depression

Negative Effects of a Multimodal Inpatient CBASP Program: Rate of Occurrence and Their Impact on Treatment Outcome in Chronic and Treatment-Resistant Depression

Effectiveness and safety of the adjunctive use of an internet-based self-management intervention for borderline personality disorder in addition to care as usual: results from a randomised controlled trial

Cancer Patients’ Preferences for Psychological Counselling: A Cross-Sectional Study Using Full-Profile Conjoint Analysis in Japan

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