ArticleEuropean archives of psychiatry and clinical neuroscience2019
It can't hurt, right? Adverse effects of psychotherapy in patients with depression.
Article in European archives of psychiatry and clinical neuroscience, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature.European child & adolescent psychiatry · 2024Pooled it
- Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis.Frontiers in pharmacology · 2023Pooled it
- Psychological interventions with older adults during inpatient postacute rehabilitation: A systematic review.Rehabilitation psychology · 2021Pooled it
- Psychological interventions to foster resilience in healthcare students.The Cochrane database of systematic reviews · 2020Pooled it
- Psychological interventions to foster resilience in healthcare professionals.The Cochrane database of systematic reviews · 2020Pooled it
- Assessing the unwanted: A systematic review of instruments used to assess negative effects of psychotherapy.Brain and behavior · 2019Pooled it
- In the Absence of Effects: An Individual Patient Data Meta-Analysis of Non-response and Its Predictors in Internet-Based Cognitive Behavior Therapy.Frontiers in psychology · 2019Pooled it
- Predictors of benefits and safety events from participation in a lifestyle therapy trial for adults with depression: A secondary analysis of the CALM randomised controlled trial.The Australian and New Zealand journal of psychiatry · 2026Trial
- Psychobiological Stress Regulation in Depressive Women Achieved Through Group Music Therapy: Results From the Randomised-Controlled Music Therapy for Depression Study.Stress and health : journal of the International Society for the Investigation of Stress · 2025Trial
- Side effects of the metacognitive training for depression compared to a cognitive remediation training in patients with depression.Scientific reports · 2021Trial
- Evaluating the UE-ATR Checklist: Nuanced Attribution in Unsuccessful Therapeutic Outcomes.Clinical psychology & psychotherapyTrial
- Distinct positive and negative dimensions of psychotherapy treatment expectations across three independent samples.Scientific reports · 2026Article
- A study design for modulating two components of the risk architecture of chronic pain: adverse life events and pain catastrophising.Frontiers in psychology · 2026Article
- Help or harm? Assessing positive and unwanted effects of a self-guided internet-based intervention for gambling problems.Internet interventions · 2025Article
- Recommendations on recording harms in randomised controlled trials of behaviour change interventions.BMJ (Clinical research ed.) · 2024Article
- What to do when the unwanted happens? Negative event management in studies on internet- and mobile-based interventions for youths and adults with two case reports.Internet interventions · 2024Article
- Precision Medicine in Depression: The Role of Proteomics and Metabolomics in Personalized Treatment Approaches.Advances in experimental medicine and biology · 2024Review
- Working with the inner critic in patients with depression using chairwork: a pilot study.Frontiers in psychiatry · 2024Article
- No pain, no gain revisited: the impact of positive and negative psychotherapy experiences on treatment outcome.Frontiers in psychology · 2024Article
- The Safety of Digital Mental Health Interventions: Systematic Review and Recommendations.JMIR mental health · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite growing awareness of occasional adverse effects of psychological treatments, only a few instruments cover side effects and other unwanted effects of psychotherapy. For the present study, the Positive and Negative Effects of Psychotherapy Scale (PANEPS) was evaluated in a population of individuals with depression who had completed at least one course of face-to-face psychotherapy. A total of 135 individuals with a current or previous depressive episode as verified by a diagnostic interview filled out the online version of the PANEPS, which is designed to capture both positive and adverse events. Factor analysis yielded four dimensions: positive effects, side effects, malpractice, and unethical conduct. Internal consistency of the individual subscales was satisfactory to excellent (Cronbach's α: 0.72 and 0.92). Positive effects were reported by virtually all patients (95.6%). At the same time, approximately half of the sample noted at least one adverse event (52.6%). Among these, side effects (38.5%) and malpractice (26.7%) were significantly more prevalent than unethical conduct (8.1%). As expected, positive effects were negatively correlated with adverse events. Our results challenge the common clinical assumption that some degree of destabilization is necessary for symptom improvement. The survey was conducted anonymously, and the sample underwent diagnostic verification. The results indicate a need for improved treatment guidelines and mechanisms to monitor treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.