title: Non-verbal communication in meetings of psychiatrists and patients with schizophrenia.
abstract: OBJECTIVE
  Recent evidence found that patients with schizophrenia display non-verbal behaviour designed to avoid social engagement during the opening moments of their meetings with psychiatrists. This study aimed to replicate, and build on, this finding, assessing the non-verbal behaviour of patients and psychiatrists during meetings, exploring changes over time and its association with patients' symptoms and the quality of the therapeutic relationship.
  
  
  METHODS
  40-videotaped routine out-patient consultations, involving patients with schizophrenia, were analysed. Non-verbal behaviour of patients and psychiatrists was assessed during three fixed, 2-min intervals using a modified Ethological Coding System for Interviews. Symptoms, satisfaction with communication and the quality of the therapeutic relationship were also measured.
  
  
  RESULTS
  Over time, patients' non-verbal behaviour remained stable, whilst psychiatrists' flight behaviour decreased. Patients formed two groups based on their non-verbal profiles, one group (n = 25) displaying pro-social behaviour, inviting interaction and a second (n = 15) displaying flight behaviour, avoiding interaction. Psychiatrists interacting with pro-social patients displayed more pro-social behaviours (P < 0.001). Patients' pro-social profile was associated reduced symptom severity (P < 0.05), greater satisfaction with communication (P < 0.001) and positive therapeutic relationships (P < 0.05).
  
  
  CONCLUSIONS
  Patients' non-verbal behaviour during routine psychiatric consultations remains unchanged, and is linked to both their psychiatrist's non-verbal behaviour and the quality of the therapeutic relationship.
authors.affiliation: Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK; Institute of Psychiatry, Kings College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Lavelle
authors.forename: S
authors.initials: S
authors.lastname: Dimic
authors.forename: C
authors.initials: C
authors.lastname: Wildgrube
authors.forename: R
authors.initials: R
authors.lastname: McCabe
authors.forename: S
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009633:Nonverbal Communication / Q000523:psychology*; D010817:Physician-Patient Relations; D011570:Psychiatry / Q000379:methods*; D011618:Psychotic Disorders / Q000523:psychology*; D012559:Schizophrenia; D012565:Schizophrenic Psychology
keywords: ethological research; interpersonal communication; psychiatry; psychosis; therapeutic relationship