No pain, no gain? Adverse effects of psychotherapy in obsessive–compulsive disorder and its relationship to treatment gains

Moritz, Steffen; Fieker, Martina; Hottenrott, Birgit; Seeralan, Tharanya; Cludius, Barbara; Kolbeck, Katharina; Gallinat, Jürgen; Nestoriuc, Yvonne

doi:10.1016/j.jocrd.2015.02.002

Cited by 61 publications

(67 citation statements)

References 23 publications

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“…Die Prävalenz lag dabei bei durchschnittlich 5-10 %. Neuere Studien mit Instrumenten zur Erhebung negativer Effekte beziehen mehr Lebensbereiche mit ein, wie u. a. soziale Stigmatisierung, Abhängigkeit vom Therapeuten, das Auftreten neuer Symptome oder interpersoneller Probleme [5][6][7][8][9][10][11]. Im Arzneimittelgesetz erfasst der Begriff Nebenwirkungen negative Effekte, die bei lege artis durchgeführter Behandlung nicht aber nach Behandlungsfehlern auftreten.…”

Section: Introductionunclassified

Negative Effekte von Psychotherapie: Häufigkeit und Korrelate in einer klinischen Stichprobe

Abeling

Müller

Stephan

et al. 2017

Psychother Psych Med

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Section: Introductionunclassified

Negative Effekte von Psychotherapie: Häufigkeit und Korrelate in einer klinischen Stichprobe

Abeling

Müller

Stephan

et al. 2017

Psychother Psych Med

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“…Table presents a summary of the key characteristics of the nine identified assessment tools. The following instruments were identified: (a) Vanderbilt Negative Indicators Scale (VNIS; Suh et al, ); (b) Unwanted Effects–Adverse Treatment Reaction checklist (UE‐ATR; Linden, ); (c) Inventory for the Assessment of Negative Effects of Psychotherapy (INEP; Ladwig et al, ); (d) Experiences of Therapy Questionnaire (ETQ; Parker, Fletcher, Berk, & Paterson, ); (e) Negative Effects Questionnaire (NEQ; Rozental, Kottorp, Boettcher, Andersson, & Carlbring, ); (f) Unwanted Events–Adverse Treatment Reactions in the context of group psychotherapy (UE‐G; Linden, Walter, Fritz, & Muschalla, ); (g) Side Effects of Psychotherapy Scale (SEPS; Moritz et al, ); (h) Exploitation Index (EI; Epstein & Simon, ); and (i) Positive and Negative Effects of Psychotherapy Scale (PANEPS; Moritz et al, ). The VNIS, UE‐ATR, and EI are therapist‐rated instruments, while the INEP, ETQ, NEQ, SEPS, and PANEPS are patient‐rated instruments; the UE‐G is a patient‐rated instrument in the context of group psychotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…Brakemeier et al, ). The prevalence of negative effects seems to vary widely from study to study, depending on the selection of instrument (Ladwig et al, ; Moritz et al, , ; Rheker et al, ); therefore, an instrument that is recognized worldwide as the “gold standard” is desirable for use in most studies in order to make study results comparable. In addition, current methodological guidelines for trials plead for the assessment of negative effects of psychotherapy using suitable evaluation methods (Guidi et al, ).…”

Section: Discussionmentioning

confidence: 99%

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Assessing the unwanted: A systematic review of instruments used to assess negative effects of psychotherapy

et al. 2019

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ObjectiveWhile the efficacy of psychotherapy in the treatment of mental disorders is well examined, systematic research into negative effects of psychotherapy seems comparatively rare. Therefore, this review evaluates instruments for assessing negative effects of psychotherapy in order to create a consensus framework and make recommendations for their assessment.MethodsThe study selection procedure follows current best‐practice guidelines for conducting systematic reviews, with 10 included studies in three databases (PsycINFO, PubMed, and Web of Science). The nine instruments identified were each critically reviewed concerning the theoretical orientation, including the assessed domains of negative effects, psychometric properties, and diagnostic characteristics.ResultsSeventeen domains of negative effects of psychotherapy were identified but inconsistently assessed by the nine instruments. Most instruments provide some initial data on their psychometric properties. Regarding diagnostic characteristics, different item‐response formats are used but often with reference to “attribution to therapy.”ConclusionThis review indicates that the existing instruments for assessing negative effects of psychotherapy cover a wide range of relevant domains without any consensus on the most important ones and their psychometric properties are usually unsatisfactory. A framework for consensus, building on the definition and conceptualization of negative effects, is synthesized, and recommendations for improving the assessment are derived.

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“…Beyond that, adverse events may also affect other areas of life and general functioning. In several studies with patients suffering from various mental disorders, 16-29% reported worsening of symptoms or new symptoms (e.g., in the course of exposure treatment; Ladwig, Rief, & Nestoriuc, 2014;Moritz et al, 2015), 6-25% reported relationship problems with partners, family, and friends (Ladwig et al, 2014;Moritz et al, 2018;, 5-9% reported problems at work (Ladwig et al, 2014), 20-25% reported fear of stigma (Moritz et al, 2015;Peth et al, 2018), and 11-19% reported financial and legal disadvantages (Ladwig et al, 2014;Moritz et al, 2018;Peth et al, 2018).…”

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confidence: 99%

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

et al. 2019

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Objectives A recent trial comparing Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and supportive psychotherapy in chronic depression found CBASP to be more effective in treating depressive symptoms. We aimed to evaluate adverse events that occurred during this trial. Materials and Method A randomized trial of chronically depressed outpatients was performed. The treatment included 32 sessions of CBASP or supportive psychotherapy. Therapists asked patients about adverse events and their intensity in each session using a standardized checklist. We analyzed the mean number of (severe) adverse events per patient up to Session 32 with gamma frailty recurrent event models. Results Two hundred and sixty patients were included in the analyses (66% female, mean age 45 years). Patients in the supportive psychotherapy group reported less severe adverse events in general, and less severe adverse events related to personal life and to occupational life than patients in the CBASP group. Less adverse events related to suicidal thoughts were reported in the CBASP compared with the supportive psychotherapy group. Conclusions Differences in the adverse events profile may be explained by the treatment elements. Adverse events related to personal and occupational life for example might be considered a necessary and expected yet temporary adverse treatment outcome of an effective CBASP treatment.

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No pain, no gain? Adverse effects of psychotherapy in obsessive–compulsive disorder and its relationship to treatment gains

Cited by 61 publications

References 23 publications

Negative Effekte von Psychotherapie: Häufigkeit und Korrelate in einer klinischen Stichprobe

Negative Effekte von Psychotherapie: Häufigkeit und Korrelate in einer klinischen Stichprobe

Assessing the unwanted: A systematic review of instruments used to assess negative effects of psychotherapy

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

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