title: Patient experience of negative effects of psychological treatment: results of a national survey†.
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.
  
  
  OBJECTIVE
  To determine the prevalence of and risk factors for perceived negative effects of psychological treatment for common mental disorders.
  
  
  METHODS
  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.
authors.affiliation: 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 m.crawford@imperial.ac.uk.
authors.forename: Mike J
authors.initials: MJ
authors.lastname: Crawford
authors.affiliation: 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.
authors.forename: Lavanya
authors.initials: L
authors.lastname: Thana
authors.affiliation: 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.
authors.forename: Lorna
authors.initials: L
authors.lastname: Farquharson
authors.affiliation: 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.
authors.forename: Lucy
authors.initials: L
authors.lastname: Palmer
authors.affiliation: 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.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hancock
authors.affiliation: 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.
authors.forename: Paul
authors.initials: P
authors.lastname: Bassett
authors.affiliation: 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.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Clarke
authors.affiliation: 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.
authors.forename: Glenys D
authors.initials: GD
authors.lastname: Parry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000145:classification* / Q000592:standards*; D012307:Risk Factors; D057566:Self Report; D014852:Wales / Q000453:epidemiology; D055815:Young Adult