title: Let's Talk About Psychosis.
abstract: BACKGROUND
  Research suggests that while patients wish to talk about positive psychotic symptoms, psychiatrists may be reluctant to do so in routine outpatient consultations.
  
  
  OBJECTIVE
  To explore the content, context and impact of discussion of positive symptoms within psychiatric consultations.
  
  
  METHODS
  Thematic analysis was applied to first discussions of positive symptoms, and overall impact assessed on the length of the consultation and the therapeutic relationship.
  
  
  RESULTS
  Sixty-five of 143 consultations contained discussion of a positive psychotic symptom. Symptom discussion neither harmed the therapeutic relationship nor lengthened the consultation. Patients' disclosures strongly corresponded with psychological models of psychosis, emphasizing personal meaning and emotional impact. In contrast, psychiatrists focused on topographical characteristics, such as frequency and location. Strengths in psychiatric practice included using open questions, positive reinforcement and offering explanations tentatively.
  
  
  CONCLUSIONS
  Findings support discussion of positive symptoms within outpatient consultations, to include necessary assessment of topography and risk alongside exploration of patients' subjective experience.
authors.forename: Ann
authors.initials: A
authors.lastname: Steele
authors.forename: Paul
authors.initials: P
authors.lastname: Chadwick
authors.forename: Rose
authors.initials: R
authors.lastname: McCabe
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D012017:Referral and Consultation; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy; D012565:Schizophrenic Psychology; D012803:Sick Role; D014342:Truth Disclosure
keywords: Communication; Positive Symptoms; Psychiatric Consultation; Psychosis