患者对心理治疗负面影响的体验：一项全国性调查的结果†。

Patient experience of negative effects of psychological treatment: results of a national survey†.

机构信息

Mike J. Crawford, MD, FRCPsych, College Centre for Quality Improvement, Royal College of Psychiatrists, London; Lavanya Thana, BSc, Centre for Mental Health, Imperial College, London; Lorna Farquharson, DClinPsych, College Centre for Quality Improvement, Royal College of Psychiatrists, London and Royal Holloway, University of London; Lucy Palmer, BSc, Elizabeth Hancock, BA, College Centre for Quality Improvement, Royal College of Psychiatrists, London; Paul Bassett, MSc, Statsconsultancy Limited, Amersham; Jeremy Clarke, MA, FBACP, College Centre for Quality Improvement, Royal College of Psychiatrists, London; Glenys D. Parry, PhD, FBPsS, Centre for Psychological Services Research, University of Sheffield, Sheffield, UK

出版信息

Br J Psychiatry. 2016 Mar;208(3):260-5. doi: 10.1192/bjp.bp.114.162628.

DOI:10.1192/bjp.bp.114.162628

PMID:26932486

Abstract

BACKGROUND

To make informed choices, patients need information about negative as well as positive effects of treatments. There is little information about negative effects of psychological interventions.

AIMS

To determine the prevalence of and risk factors for perceived negative effects of psychological treatment for common mental disorders.

METHOD

Cross-sectional survey of people receiving psychological treatment from 184 services in England and Wales. Respondents were asked whether they had experienced lasting bad effects from the treatment they received.

RESULTS

Of 14 587 respondents, 763 (5.2%) reported experiencing lasting bad effects. People aged over 65 were less likely to report such effects and sexual and ethnic minorities were more likely to report them. People who were unsure what type of therapy they received were more likely to report negative effects (odds ratio (OR) = 1.51, 95% CI 1.22-1.87), and those that stated that they were given enough information about therapy before it started were less likely to report them (OR = 0.65, 95% CI 0.54-0.79).

CONCLUSIONS

One in 20 people responding to this survey reported lasting bad effects from psychological treatment. Clinicians should discuss the potential for both the positive and negative effects of therapy before it starts.

摘要

背景

为了做出明智的选择，患者需要了解治疗的负面和正面效果。关于心理干预的负面效果的信息很少。

目的

确定常见精神障碍心理治疗中感知到的负面效果的发生率和危险因素。

方法

对英格兰和威尔士 184 个服务机构中接受心理治疗的人群进行横断面调查。受访者被问及他们是否曾因接受的治疗而产生持久的不良影响。

结果

在 14587 名受访者中，有 763 人（5.2%）报告出现持久的不良影响。65 岁以上的人群不太可能报告此类影响，而性少数群体和少数族裔更有可能报告此类影响。不确定他们接受的是哪种类型的治疗的人更有可能报告负面效果（比值比（OR）=1.51，95%置信区间（CI）为 1.22-1.87），而那些表示在开始治疗前获得足够治疗信息的人不太可能报告负面效果（OR=0.65，95%CI 0.54-0.79）。