title: Are therapeutic relationships in psychiatry explained by patients' symptoms? Factors influencing patient ratings.
abstract: OBJECTIVE
  To investigate the therapeutic relationship and how it is influenced by sociodemographic and clinical factors.
  
  
  METHODS
  This study analysed self-ratings of the therapeutic relationship in 90 first-admitted, 72 long-term hospitalised and 41 out-patients with schizophrenia along with 249 alcoholic and 42 depressive in-patients and their association with sociodemographic and clinical variables. In all the patients, the therapeutic relationship was assessed using a simple scale based on three items.
  
  
  RESULTS
  The therapeutic relationship differed significantly across groups. It was rated most positively by alcoholic patients and least positively by long-term hospitalised schizophrenia patients. Increased observer-rated psychopathology was significantly associated with a poorer therapeutic relationship in all groups except the hospitalised schizophrenia patients. In this group, increased self-rated symptoms were associated with a poorer relationship. In multiple regression analyses, 3-28% of the relationship variance was explained by psychopathology. CONCLUSIONS; Patient ratings of the therapeutic relationship were partially explained by psychopathology, leaving the greater part of the variance to be explained by factors other than sociodemographic and clinical characteristics.
authors.affiliation: Unit for Social and Community Psychiatry, Barts and the London School of Medicine, Newham Centre for Mental Health, London E13 8SP, UK. r.mccabe@qmul.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: McCabe
authors.forename: S
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D000704:Analysis of Variance; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology; D012647:Self-Assessment; D012959:Socioeconomic Factors; D006113:United Kingdom