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Communication and Medicine

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Professional-patient communication in the treatment of mental illness: A review

Imren Hassan / Rosemarie McCabe / Stefan Priebe
Published Online: 2007-12-04 | DOI: https://doi.org/10.1515/CAM.2007.018

Abstract

The quality of the professional–patient relationship in the treatment of mental illness predicts patient outcome. Hence, we conducted a review of recorded professional–patient communication to identify existing research, methods, and findings. Sixteen studies focused on (i) how psychiatric symptoms are manifested in patient communication; (ii) the role of therapist communication in patient improvement; (iii) the influence of sociodemographic characteristics on doctor–patient communication; and (iv) how patients and professionals jointly construct therapeutic interactions. The findings were disparate and included (a) patient nonverbal communication is impaired in depression and schizophrenia; (b) the use of specific therapeutic skills led to improvement in depression; high expressed emotion (criticism and emotional over-involvement) in treating schizophrenia was a state rather than trait characteristic of therapists; (c) patient gender, income, and education influenced communication about depression, anxiety, and medication; and (d) psychiatrists' varying institutional agendas, which sometimes competed with patients' agendas, strongly shaped their consultations. Few studies investigated two-way professional–patient communication, with most focusing on either patient or therapist communication in isolation from the other. Finally, methodological advances in linking communication processes with treatment outcomes in large-scale observational studies and trials are a challenge for research on medical communication.

Keywords: doctor–patient communication; interaction; audio/audiovisual recording; mental illness; schizophrenia; depression

About the article

Imren Hassan

Imren Hassan is conducting a Ph.D. at the Unit for Social and Community Psychiatry, Barts and the London School of Medicine. Her Ph.D. is on doctor–patient communication in a psychiatric outpatient setting. She is using conversation analysis to analyze audiovisually recorded outpatient consultations, and is interested in how doctors and patients talk about suicide and how risk is assessed.

Rosemarie McCabe

Rosemarie McCabe is Senior Research Fellow at the Unit for Social and Community Psychiatry, Barts and the London School of Medicine. Her research is concerned with psychological constructs and social processes relevant to healthcare. She has a particular interest in communication in the context of psychosis and is currently working on how symptoms are manifested in social interaction; communication and therapeutic relationships; and integrating qualitative and quantitative methods to understand how treatment processes influence patient outcome.

Stefan Priebe

Stefan Priebe is Professor of Social and Community Psychiatry, Barts and the London School of Medicine. His research activities focus on three areas: (i) mental health service research including controlled trials and outcome studies; (ii) patient views (e.g., subjective quality of life and treatment satisfaction) and therapeutic relationships in mental healthcare; and (iii) studies on the history and concepts of mental healthcare.


*Address for correspondence: Unit for Social and Community Psychiatry, Barts and the London School of Medicine, Queen Mary, University of London, Newham Centre for Mental Health, London E13 8SP, UK.


Published Online: 2007-12-04

Published in Print: 2007-10-26


Citation Information: Communication & Medicine, Volume 4, Issue 2, Pages 141–152, ISSN (Online) 1613-3625, ISSN (Print) 1612-1783, DOI: https://doi.org/10.1515/CAM.2007.018.

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