Is psychotherapy for functional somatic syndromes harmful? A mixed methods study on negative effects

INTRODUCTION

Concern for negative effects of psychotherapy for functional somatic syndromes (FSS) has been expressed by clinicians and some patient associations, which may prevent patients from seeking treatment. Therefore, we sought to explore the occurrence and characteristics of negative effects from group-based psychotherapy as experienced by patients with severe or multiple FSS.

METHODS

An adapted version of the explanatory sequential mixed methods design was applied. We used data from an on-going pilot study on Acceptance and Commitment Therapy and Mindfulness-Based Stress Reduction. Negative effects were measured by Inventory for the assessment of Negative Effects of Psychotherapy (INEP). In addition, telephone interviews were conducted with randomly chosen patients and patients who reported negative effects. The latter were asked to elaborate on their INEP response. Quantitative data were analysed descriptively while interview transcripts were explored by thematic analysis.

RESULTS

Eighty patients responded to the questionnaire (89%). Negative effects to different extent (from 'slightly agree' to 'fully agree') were reported by 25 (31%). The most frequent negative effects were dependence on the therapist (12%), feeling down after therapy (6%) and insurance problems (7%). By exploring 27 participants' experiences of negative effects 3 main themes were identified: relations in therapy, outcome and transition from therapy to everyday life.

CONCLUSION

Patients with FSS reported a few specific negative effects, all with low frequency. Generally, therapy was well-received. Some patients did however express negative effects both within and outside the therapeutic context. It is important to inform patients about potential negative effects prior to psychotherapy.

Reading Processes of University Students with Dyslexia - An Examination of the Relationship between Oral Reading and Reading Comprehension

The purpose of this study was to examine the quality of oral reading and how it relates to reading comprehension in students with dyslexia. A group of Danish university students with dyslexia (n = 16) and a comparison group of students with no history of reading problems (n = 16) were assessed on their oral reading performance when reading a complex text. Along with reading speed, we measured not only the number and quality of reading errors but also the extent and semantic nature of the self-corrections during reading. The reading comprehension was measured through aided text retellings. The results showed that, as a group, the dyslexics performed poorer on most measures, but there were notable within-group differences in the reading behaviours and little association between how well university students with dyslexia read aloud and comprehended the text. These findings suggest that many dyslexics in higher education tend to focus their attention on one subcomponent of the reading process, for example, decoding or comprehension, because engaging in both simultaneously may be too demanding for them. Copyright © 2016 John Wiley & Sons, Ltd.

In vitro studies of the synergism of piperacillin and netilmicin against blood culture isolates

The purpose of this study was to evaluate the in vitro synergism between piperacillin and netilmicin against microorganisms isolated from Danish patients with septicemia and to examine the influence of inactivation of piperacillin among these bacteria on the synergy results. A total of 132 stains was examined: Escherichia coli 20, indole-positive Proteus 17, Klebsiella pneumoniae 18, Enterobacter cloacae 20, Pseudomonas aeruginosa 20, Staphylococcus aureus 20, and coagulase-negative staphylococci 17. Synergy testing was performed by checkerboard titration in microtiter trays. The ability of the strains to inactivate piperacillin was examined by the clover-leaf test. Synergism was found for 52% of the strains and partial synergism for 32%. Antagonism was not found. Of the piperacillin-resistant strains synergism could be demonstrated in 80% compared with 33% of the piperacillin-susceptible strains (p less than 0.001). No significant correlation was seen between the results of the synergy test and the results of the susceptibility test to netilmicin. The frequency of piperacillin inactivation according to the clover-leaf test was significantly higher among the strains with synergism than among all the others (p less than 0.02). The combination of piperacillin and netilmicin gave good results concerning the in vitro synergism. This synergism was probably sometimes caused by netilmicin disturbing the bacterial production of piperacillin-inactivating proteins.