Why do some patients with schizophrenia want to be engaged in medical decision making and others do not?

Objective: Treatment guidelines for schizophrenia recommend that medical decisions should be shared between patients with schizophrenia and their physicians. Our goal was to determine why some patients want to participate in medical decision making and others do not.

Method: To identify determinants of participation preferences in schizophrenia patients (ICD-10 criteria) and in a nonpsychiatric comparison group (multiple sclerosis), we undertook a cross-sectional survey in 4 psychiatric and neurologic hospitals in Germany.

Can psychiatrists and neurologists predict their patients' participation preferences?

There is evidence that an optimal match of patients' participation preferences improves health outcomes. Since it is unknown whether psychiatrists and neurologists can predict their patients' participation preferences we performed a cross-sectional survey involving N = 101 inpatients with schizophrenia/schizoaffective disorder and N = 102 inpatients with multiple sclerosis. Both patients and their physicians in charge were surveyed with respect to the patients' participation preferences, using the Autonomy Preference Index and a global estimate.