Patients' and psychiatrists' perceptions of clinical decisions during schizophrenia treatment.
Shared decision making is advocated for patients with schizophrenia. However, there is limited knowledge as to which events are actually considered to be decisions by psychiatrists and patients. Semistructured interviews with regard to clinical decisions of the preceding week were performed with psychiatrists and inpatients with schizophrenia. There was good correspondence between patients and psychiatrists regarding decisional topics but poor correspondence regarding individual decisions. Medication issues were the most prominent, but other topics were also frequently cited. Not being included in decisions was associated with patients' desire to make the decisions differently. Patients treated involuntarily felt more often that they were not included in decisions and wanted to make different decisions. Thus, many patients do not feel involved in treatment decisions and are at the risk of noncompliance since they state that they would have made decisions differently from their psychiatrists. This is especially true of those being treated involuntarily.
Hamann
Johannes
J
Klinik und Poliklinik für Psychiatrie und Psychotherapie der TU München, München, Germany. j.hamann@lrz.tum.de
Mendel
Rosmarie T
RT
Fink
Barbara
B
Pfeiffer
Herbert
H
Cohen
Rudolf
R
Kissling
Werner
W
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003134:Commitment of Persons with Psychiatric Disorders; D003657:Decision Making; D005260:Female; D005858:Germany; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006783:Hospitals, State; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents