Doctors have trouble talking to patients about psychotic symptoms

November 14, 2002

Doctors have trouble talking to patients about psychotic symptoms, finds a study in this week's BMJ.

Researchers analysed 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder at two psychiatric outpatient clinics in London.

They found that patients actively attempted to talk about the content of their psychotic symptoms, such as hallucinations and delusions, and the distress associated with these symptoms. However, doctors tended to hesitate and avoid answering the patients' questions, indicating a reluctance to engage with these concerns.

When there was an informal carer present, the doctor also smiled or laughed in response to patients' assessments of and questions about their symptoms. This response to patients' distress may be an obstacle to successful engagement, say the authors.

Proactively addressing patients' distress about their psychotic symptoms may lead to a more satisfactory outcome of the consultation itself and improve engagement of such patients with health services, they conclude.


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