Patients’ and Psychiatrists’ Perceptions of Clinical Decisions During Schizophrenia Treatment
Abstract
Shared decision making is advocated for patients with schizophrenia. However, there is limited knowledge as to which events are actually considered to be decisions by psychiatrists and patients. Semistructured interviews with regard to clinical decisions of the preceding week were performed with psychiatrists and inpatients with schizophrenia. There was good correspondence between patients and psychiatrists regarding decisional topics but poor correspondence regarding individual decisions. Medication issues were the most prominent, but other topics were also frequently cited. Not being included in decisions was associated with patients' desire to make the decisions differently. Patients treated involuntarily felt more often that they were not included in decisions and wanted to make different decisions. Thus, many patients do not feel involved in treatment decisions and are at the risk of noncompliance since they state that they would have made decisions differently from their psychiatrists. This is especially true of those being treated involuntarily.
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Decreased involvement in care was associated with involuntary status.
“Decreased involvement in care was also associated with involuntary status (20,31,32).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [20]
Involuntary treatment was associated with an increased risk of the admission being perceived as coercive or procedurally unfair when compared to those receiving voluntary care.
“Involuntary treatment is by definition associated with objective coercion, but it was also associated with an increased risk of the admission being perceived as coercive (for example experiencing a lack of control or agency) or procedurally unfair when compared to those receiving voluntary care (10,11,15,18–31).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [20]
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“SDM aims at engaging patients to a greater extent in medical decisions by decreasing the information and power asymmetry between doctors and patients (Charles et al., 1997).”
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Self-citationShared decision making for in‐patients with schizophrenia
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Self-citationDo Patients With Schizophrenia Wish to Be Involved in Decisions About Their Medical Treatment?
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Shared decision making interventions for people with mental health conditions
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The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review
Corderoy, A., Kisely, S., Zirnsak, T., & Ryan, C. J. (2025) · Psychiatry, Psychology and Law · doi:10.1080/13218719.2024.2346734 · Cited by 19 · see citing works
“Decreased involvement in care was also associated with involuntary status (20,31,32).”
Konrad, J., Loos, S., Neumann, P., Zentner, N., Mayer, B., Slade, M., Jordan, H., De Rosa, C., Del Vecchio, V., Égerházi, A., et al. (2015) · Journal of Mental Health · doi:10.3109/09638237.2014.951478 · Cited by 7 · see citing works
- Authors
- Hamann, J., Mendel, R. T., Fink, B., Pfeiffer, H., Cohen, R., & Kissling, W.
- Affiliations
- Klinik und Poliklinik für Psychiatrie und Psychotherapie (DE)
- Isar-Amper-Klinikum München-Ost (DE)
- Corresponding author
- Hamann, Johannes
- Mendel, Rosmarie T.
- Fink, Barbara
- Cohen, Rudolf
- Kissling, Werner
- ORCID
- Hamann, Johannes
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2008-04
- Volume
- 196
- Issue
- 4
- Pages
- 329-332
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2085567585
- Cited by
- 69
- References
- 10
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 7 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 10 · 2015: 6 · 2014: 7 · 2013: 5 · 2012: 4
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- schizophrenia, shared decision-making, patient participation in treatment decisions, psychiatrists' perspectives, patient perspectives, involuntary treatment, treatment non-adherence
- MeSH terms
- Adult, Attitude of Health Personnel, Commitment of Persons with Psychiatric Disorders, Decision Making, Female, Germany, Hospitalization, Hospitals, Psychiatric, Hospitals, State, Humans, Interview, Psychological, Male, Middle Aged, Patient Discharge, Patient Participation, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Patient Satisfaction
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