How emotions emerge and are dealt with in first diagnostic consultations in psychiatry.
OBJECTIVE
To illustrate how patients introduce cues and concerns during clinical consultations and how psychiatrists respond to them.


METHODS
Sixteen psychiatrists recorded 104 first diagnostic consultations, coded with the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Cues, concerns and responses were analyzed in relation to patient gender and ICD-10 diagnosis, and psychiatrists' age, gender, clinical experience and consultation process.


RESULTS
Cues were more frequent among female patients and were equally distributed among diagnostic categories. Concerns were more frequent among patients with "Mood" or "Neurotic" disorders. Psychiatrists' responses to cues tended to "provide space" without being explicit. Referral to the affective part was restricted to concerns which had been solicited by the psychiatrist. Empathic responses were infrequent. Cues and concerns received more attention by female psychiatrists.


CONCLUSIONS
The study confirms gender differences in expressing and dealing with emotions both by patients and psychiatrists. Females tend to give more space to this topic. Psychiatrists 'responses differed according to cues, concerns, gender, diagnosis and to who prompted the cue/concern, showing a preference for topics introduced by themselves.


CONCLUSIONS
The VR-CoDES is a useful tool to define the strategies psychiatrists adopt when handling patients' emotions in terms of cues and concern.
Department of Public Health and Community Medicine, University of Verona, Verona, Italy. lidia.delpiccolo@univr.it
Lidia
L
Del Piccolo
Maria Angela
MA
Mazzi
Claudia
C
Goss
Michela
M
Rimondini
Christa
C
Zimmermann
D000328:Adult; D000367:Age Factors; D003142:Communication; D003463:Cues; D004644:Emotions; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D019370:Observation; D010045:Outpatients; D010817:Physician-Patient Relations; D011570:Psychiatry; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012737:Sex Factors; D014743:Videotape Recording