Allison Stephen, Looi Jeffrey Cl, Kisely Steve, Bastiampillai Tarun
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; and Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.
Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia; and Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.
Australas Psychiatry. 2025 Feb;33(1):25-27. doi: 10.1177/10398562241282736. Epub 2024 Sep 7.
The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines on mood disorders recommend psychotherapy as foundational care for patients with acute depression with minimal discussion of any potential adverse effects. Randomised controlled trial evidence on psychotherapy adverse effects is limited. This is problematic because clinicians must balance the benefits of treatment against the harms, and clinical decisions become skewed without data on adverse effects. We suggest that clinical practice guidelines should be more guarded about recommending psychotherapy and add consensus statements on adverse effects for informed consent and clinical decision-making.
澳大利亚和新西兰皇家精神科医学院关于情绪障碍的临床实践指南推荐心理治疗作为急性抑郁症患者的基础治疗方法，但对任何潜在不良反应的讨论极少。关于心理治疗不良反应的随机对照试验证据有限。这是个问题，因为临床医生必须在治疗益处和危害之间取得平衡，而没有不良反应数据会使临床决策产生偏差。我们建议临床实践指南在推荐心理治疗时应更加谨慎，并增加关于不良反应的共识声明，以实现知情同意和临床决策。
