Giving information and involving in treatment: what do psychiatrists think? A review

Abstract

A narrative review of studies on the psychiatrists' opinion about the information process and the factors that may influence the extent to which patients are informed and involved in the information process. A literature review, without restrictions of time, was carried out using Medline and PsychInfo databases. Twenty three studies of interest were identified. The diagnosis of depression, anxiety and substances abuse are comunicated in a high percentage of cases; while the diagnosis of schizophrenia and other psychotic disordes are often concealed to patients. As far as pharmacological treatment is concerned, psychiatrists are more inclined to communicate those side effects which from their point of view are considered as less stressfull for the patient. No studies refer to the comunication of prognosis. The reasons adduced by psychiatrists for informing or not informing regard the etiology and the validity of some psychiatric diagnoses, the cognitive difficulties of patients, worries about stigmatizing or damaging patients. The choice to involve patients in treatment should be made from the prospective of promoting patient's well being rather than to depend on psychiatrists' communication difficulties, prejudices or on a habit of a paternalistic relationship style.