Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2002 Nov 16;325(7373):1148-51.
doi: 10.1136/bmj.325.7373.1148.

Engagement of patients with psychosis in the consultation: conversation analytic study

Rosemarie McCabe  1 , Christian Heath, Tom Burns, Stefan Priebe
Affiliations
Multicenter Study

Engagement of patients with psychosis in the consultation: conversation analytic study

Rosemarie McCabe et al. BMJ. .

Abstract

Objective: To investigate how doctors engage with patients with psychotic illness in routine consultations.

Design: Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder.

Setting: Two psychiatric outpatient clinics in east London and south west London.

Participants: 7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder.

Main outcome measure: Mutual engagement in communication during the consultation.

Results: Patients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients' concerns about their psychotic symptoms.

Conclusions: Patients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients' concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Department of Health. The NHS plan: a plan for investment, a plan for reform. London: Department of Health; 2000.
    1. Department of Health. Modern standards and service models: national service framework for mental health. London: Department of Health; 1999.
    1. Killaspy H, Banerjee S, King M, Lloyd M. Prospective controlled study of psychiatric out-patient non-attendance. Br J Psychiatry. 2000;176:160–165. - PubMed
    1. Drew P, Chatwin J, Collins S. Conversation analysis: a method for research into interactions between patients and healthcare professionals. Health Expect. 2001;4:58–70. - PMC - PubMed
    1. Bergmann J. Veiled morality: notes on discretion in psychiatry. In: Drew P, Heritage J, editors. Talk at work. Cambridge: Cambridge University Press; 1992.

Publication types