Better patient knowledge and worse treatment outcome after written patient information in inpatient cognitive behaviour therapy as compared to non-informed patients

Patient information and education is an important task in medicine in general and psychotherapy in particular. This can be done verbally but also by written materials (bibliotherapy). Cognitive behaviour therapists from an inpatient department of behavioural medicine were provided with specially developed brochures on phobia, general anxiety, hypochondriasis, cognition and emotion, coping, and chronic illness, which they could use to their discretion in the treatment of their patients, who had been randomized either to a bibliotherapy group (n = 196) or a control group (n = 181). At the end of the treatment, patients in the bibliotherapy group showed significantly better health knowledge than control group patients. Patients with less education showed the biggest increase. Indicators of the treatment process showed for the bibliotherapy group less understanding of the illness and treatment process, less mutual understanding, less well-being during the session, and sympathy. At the end of the treatment patients and therapists alike rated the outcome in the bibliotherapy group less favourable than in the control group. The conclusion is that patient information can have side effects, which should get proper attention in research and clinical practice