title: Shared decision-making in ongoing outpatient psychiatric treatment.
abstract: OBJECTIVE
  Research on patient involvement in decision-making in psychiatry has focused on first encounters. This study investigated what decisions are made, level of patient involvement and factors influencing patient involvement in ongoing outpatient visits.
  
  
  METHODS
  72 visits conducted by 20 psychiatrists were video recorded. Patients had a diagnosis of depression or schizophrenia.
  
  
  RESULTS
  On average, there was one medication related and one other decision per visit. Some psychiatrists involved patients more in decisions, as did female psychiatrists. Involvement was lower when patients had more negative symptoms.
  
  
  CONCLUSIONS
  Involvement in decision-making appears to be influenced by the individual psychiatrist and specific symptoms but not visit length.
  
  
  CONCLUSIONS
  It is noteworthy that patient involvement is not influenced by length of the visit given that this would be a barrier in busy clinical practice. The next step would be to identify the communication patterns of psychiatrists who involve patients more in decision-making.
authors: Unit for Social and Community Psychiatry, Newham Centre for Mental Health, London, UK. r.mccabe@qmul.ac.uk
authors: Rose
authors: R
authors: McCabe
authors: Husnara
authors: H
authors: Khanom
authors: Peter
authors: P
authors: Bailey
authors: Stefan
authors: S
authors: Priebe
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003627:Data Interpretation, Statistical; D003657:Decision Making; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010358:Patient Participation; D010817:Physician-Patient Relations; D011594:Psychometrics; D036301:Qualitative Research; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy; D012959:Socioeconomic Factors; D006113:United Kingdom; D055815:Young Adult