Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Brief Reports   |    
Communicating a Schizophrenia Diagnosis to Patients and Families: A Qualitative Study of Mental Health Clinicians
Sue Outram, Ph.D.; Gillian Harris, M.A.; Brian Kelly, F.R.A.N.Z.C.P., Ph.D.; Martin Cohen, M.B. B.S., F.R.A.N.Z.C.P.; Harsimrat Sandhu, M.B. B.S., F.R.A.N.Z.C.P.; Marina Vamos, M.B. B.S., F.R.A.N.Z.C.P.; Tomer T. Levin, M.B. B.S., F.A.P.M.; Yulia Landa, Psy.D., M.S.; Carma L. Bylund-Lincoln, Ph.D.; Carmel Loughland, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300202
View Author and Article Information

Dr Outram is with the School of Medicine and Public Health and with the Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: sue.outram@newcastle.edu.au). Ms. Harris, Prof. Kelly, and Dr. Loughland are with the Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, New South Wales. Dr. Cohen, Dr. Sandhu, and Dr. Vamos are with the Department of Psychiatry, Hunter New England Health, Newcastle, New South Wales. Dr. Levin and Dr. Bylund-Lincoln are with the Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City. Dr. Landa is with the Department of Psychiatry and the Department of Public Health, Division of Prevention, Weill Medical College of Cornell University, New York City.

Copyright © 2014 by the American Psychiatric Association


Objective  The aim of this research was to explore mental health clinicians’ experiences and perceptions of discussing a diagnosis of schizophrenia with their patients. The results of this research will inform a communication skills training program for psychiatry trainees.

Methods  Semistructured interviews were conducted with 16 mental health clinicians from public mental health services in New South Wales, Australia. Interviews were recorded and transcribed for qualitative analysis.

Results  Although most clinicians supported the need to give patients a named diagnosis of schizophrenia, most gave multiple reasons for not doing so in practice. The reasons given centered on concerns for the patient; they included fear of making an incorrect diagnosis, fear of the patient’s distress, and harm from stigma.

Conclusions  Mental health clinicians need to reflect on their own feelings, examine personal identification with their patients, and recognize the subtle interplay of hope and pessimism in their communication of a schizophrenia diagnosis.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).



Clafferty  RA;  McCabe  W;  Brown  KW:  Conspiracy of silence? Telling patients with schizophrenia their diagnosis.  Psychiatric Bulletin 25:336–339, 2001
Mitchell  AJ:  Reluctance to disclose difficult diagnoses: a narrative review comparing communication by psychiatrists and oncologists.  Supportive Care in Cancer 15:819–828, 2007
[CrossRef] | [PubMed]
Seeman  MV:  Breaking bad news: schizophrenia.  Journal of Psychiatric Practice 16:269–276, 2010
[CrossRef] | [PubMed]
Fisher  M:  Telling patients with schizophrenia their diagnosis: patients expect a diagnosis.  British Medical Journal 321:385, 2000
[CrossRef] | [PubMed]
Jutel  A;  Nettleton  S:  Towards a sociology of diagnosis: reflections and opportunities.  Social Science and Medicine 73:793–800, 2011
[CrossRef] | [PubMed]
Magliano  L;  Fiorillo  A;  Malangone  C  et al:  Views of persons with schizophrenia on their own disorder: an Italian participatory study.  Psychiatric Services 59:795–799, 2008
[CrossRef] | [PubMed]
Levin  TT;  Kelly  BJ;  Cohen  M  et al:  Case studies in public-sector leadership: using a psychiatry e-list to develop a model for discussing a schizophrenia diagnosis.  Psychiatric Services 62:244–246, 2011
[CrossRef] | [PubMed]
Kissane  DW;  Bylund  CL;  Banerjee  SC  et al:  Communication skills training for oncology professionals.  Journal of Clinical Oncology 30:1242–1247, 2012
[CrossRef] | [PubMed]
Corbin  JM;  Strauss  AC:  Basics of Qualitative Research Techniques and Procedures for Developing Grounded Theory .  London,  Sage, 1998
Schneider  B;  Scissons  H;  Arney  L  et al:  Communication between people with schizophrenia and their medical professionals: a participatory research project.  Qualitative Health Research 14:562–577, 2004
[CrossRef] | [PubMed]
Phillips  J;  Pond  CD;  Paterson  NE  et al:  Difficulties in disclosing the diagnosis of dementia: a qualitative study in general practice.  British Journal of General Practice 62:e546–e553, 2012
[CrossRef] | [PubMed]
Seale  C;  Chaplin  R;  Lelliott  P  et al:  Antipsychotic medication, sedation and mental clouding: an observational study of psychiatric consultations.  Social Science and Medicine 65:698–711, 2007
[CrossRef] | [PubMed]
Baile  WF;  Beale  EA:  Giving bad news to cancer patients: matching process and content.  Journal of Clinical Oncology 19:2575–2577, 2001
Guthrie  E;  Tattan  T;  Williams  E  et al:  Sources of stress, psychological distress and burnout in psychiatrists: comparison of junior doctors, senior registrars and consultant psychiatrists.  Psychiatric Bulletin 23:207–212, 1999
Ramirez  AJ;  Graham  J;  Richards  MA  et al:  Burnout and psychiatric disorder among cancer clinicians.  British Journal of Cancer 71:1263–1269, 1995
[CrossRef] | [PubMed]
References Container

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 22.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 22.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 38.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 22.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 38.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles