Abstract
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. 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. 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). 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.
Highlights
The Dutch psychiatrist Ru€mke suggested, in 1941, that psychiatrists could intuitively and very quickly recognize a patient with schizophrenia based predominantly on the patient’s non-verbal behaviour [1]
Patients with schizophrenia can be classified into two groups based on their non-verbal behaviour; one group displaying non-verbal behaviour designed to avoid social interaction, and a second displaying non-verbal behaviour inviting social interaction
Two key characteristics of non-verbal communication in schizophrenia that have yet to be investigated are (i) the variability of patients’ nonverbal behaviour, both over time and between patients in this heterogeneous diagnostic group and (ii) the interpersonal aspects of patients’ nonverbal communication; the influence of patients’ non-verbal behaviour on those they interact with and the resulting relationships. These characteristics will form the focus of the current study
Summary
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 nonverbal behaviour of patients and psychiatrists during meetings, exploring changes over time and its association with patients’ symptoms and the quality of the therapeutic relationship. 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. 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). Patients with schizophrenia can be classified into two groups based on their non-verbal behaviour; one group displaying non-verbal behaviour designed to avoid social interaction, and a second displaying non-verbal behaviour inviting social interaction. Patients’ non-verbal behaviour is associated both with the behaviour of their psychiatrist and the quality of the therapeutic relationship
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