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Can Psychiatrists and Neurologists Predict Their Patients' Participation Preferences?

Hamann, Johannes MD*; Mendel, Rosmarie PhD*; Schebitz, Matthias MD*; Reiter, Sarah*; Bühner, Markus PhD; Cohen, Rudolf PhD*; Berthele, Achim MD; Kissling, Werner MD*

The Journal of Nervous and Mental Disease: April 2010 - Volume 198 - Issue 4 - p 309-311
doi: 10.1097/NMD.0b013e3181d6128c
Brief Reports

There is evidence that an optimal match of patients' participation preferences improves health outcomes. Since it is unknown whether psychiatrists and neurologists can predict their patients' participation preferences we performed a cross-sectional survey involving N = 101 inpatients with schizophrenia/schizoaffective disorder and N = 102 inpatients with multiple sclerosis. Both patients and their physicians in charge were surveyed with respect to the patients' participation preferences, using the Autonomy Preference Index and a global estimate. Most patients wished to participate in medical decision making. Doctors performed poorly when predicting their individual patients' participation preferences and tended to overestimate their patients' participation preferences. A longer duration of the hospital stay did not improve the accuracy of doctors' estimates. Thus, neurologists and psychiatrists fail at predicting their patients' participation preferences accurately, which might challenge patients' treatment satisfaction. More attention in the consultation should be paid to patients' preferences.

*Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, München, Germany; †Institut für Psychologie, Karl-Franzens-Universität, Graz, Austria; and ‡Klinik und Poliklinik für Neurologie, Technische Universität München, München, Germany.

Supported by funds from the Kommission für klinische Forschung (KKF), Fakultät für Medizin, Technische Universität München.

Approved by the institutional review board (Ethikkommission) of the Technische Universität München.

Send reprint requests to PD Dr. Johannes Hamann, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Germany. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.