"How to speak to your psychiatrist": shared decision-making training for inpatients with schizophrenia

Abstract

Objective: Involving patients with mental illness in shared decision making about their treatment has recently attracted attention, but existing interventions may insufficiently motivate or enable patients with schizophrenia to behave more actively. This study evaluated a new intervention.

Methods: In a pilot study 61 inpatients with schizophrenia or schizoaffective disorder from a psychiatric hospital in Germany were randomly assigned to receive shared decision-making training (N=32) or cognitive training (N=29, control condition).

Results: The shared decision-making training yielded higher participation preferences and increased patients' desire to have more responsibility in treatment decisions, which continued to the six-month follow-up. Patients in the intervention group became more skeptical of treatment and were perceived as more "difficult" by their psychiatrists.

Conclusions: Training in shared decision making was highly accepted by patients and changed attitudes toward participation in decision making. There were some hints that it might generate beneficial long-term effects.

Trial registration: ClinicalTrials.gov NCT00885716.