Effects of a question prompt sheet on active patient behaviour: a randomized controlled trial with depressed outpatients.

Background: A deeper engagement into medical decision-making is demanded by treatment guidelines for patients with affective disorders. There is to date little evidence on what facilitates active behaviour of patients with depression. In general medicine 'question prompt sheets' (QPSs) have been shown to change patients' behaviour in the consultation and improve treatment satisfaction but there is no evidence for such interventions for mental health settings.

How should patients behave to facilitate shared decision making--the doctors' view.

Objective: To study how physicians feel about patients' efforts to be engaged in shared decision making (SDM). STUDY SETTING AND DESIGN: Survey of physicians from distinctly different medical disciplines (238 psychiatrists and 169 vascular surgeons). Participants were requested to judge which patient behaviours they find helpful and which behaviours detrimental for SDM.

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.

Psychiatrists' use of shared decision making in the treatment of schizophrenia: patient characteristics and decision topics.

Objective: Shared decision making is advocated as a way of involving patients in medical decisions, but it can be achieved only when both patients and physicians commit to sharing decisions. This study explored psychiatrists' views of shared decision making in schizophrenia treatment.

Method: A structured questionnaire was given to 352 psychiatrists at the 2007 congress of the German Society of Psychiatry, Psychotherapy, and Nervous Diseases to determine their self-reported decision-making styles.

Context, complexity, and cognitive processing in schizophrenia.

Background: Cohen et al.'s (1990, 1999) concept of context has been employed to explain various schizophrenic cognitive deficits. Braver et al.

Patients' and psychiatrists' perceptions of clinical decisions during schizophrenia treatment.

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.

Shared decision making and long-term outcome in schizophrenia treatment.

Objective: Compliance with antipsychotic medication is a major issue in schizophrenia treatment, and noncompliance with antipsychotic treatment is closely related to relapse and rehospitalization. An enhanced involvement of patients with schizophrenia in treatment decisions ("shared decision making") is expected to improve long-term compliance and reduce rehospitalizations. The aim of the present analysis was to study whether shared decision making (SDM) in antipsychotic drug choice would influence long-term outcome.

The Brief Motor Scale (BMS) for the assessment of motor soft signs in schizophrenic psychoses and other psychiatric disorders.

Subtle motor impairment is an important aspect of neurological soft signs (NSS) which are frequently found in psychiatric patients-particularly schizophrenic patients. On the basis of data collected in previous studies using two different NSS scales, the most reliable and discriminative signs of motor impairment were identified to construct a brief 10-item rating scale. Subsequently, the new scale was applied to a sample of subacute patients with schizophrenic psychoses (N = 82) and healthy controls (N = 33).

Motoric neurological soft signs and psychopathological symptoms in schizophrenic psychoses.

Motoric neurological soft signs (NSS) were investigated by means of the Brief Motor Scale (BMS) in 82 inpatients with DSM-III-R schizophrenic psychoses. To address potential fluctuations of psychopathological symptoms and extrapyramidal side effects, patients were examined in the subacute state, twice at an interval of 14 days on the average. NSS were significantly correlated with severity of illness, lower social functioning, and negative symptoms.

Do patients with schizophrenia wish to be involved in decisions about their medical treatment?

Objective: Little is known about the desire of patients with schizophrenia to be involved in medical decisions affecting their treatment.

Method: The authors administered the Autonomy Preference Index to 122 inpatients with schizophrenia. In addition, the patients filled out the Drug Attitude Inventory.

How do psychiatrists choose among different antipsychotics?

Objective: We attempted to determine the decision rules psychiatrists use in the choice of antipsychotic drugs for inpatients with schizophrenia.

Methods: Interviews were conducted with 50 hospital psychiatrists in Southern Germany. Each physician was interviewed with respect to the reasons for his antipsychotic drug choice in the cases of three patients with a diagnosis of schizophrenia.

Semantic categorization in the human brain: spatiotemporal dynamics revealed by magnetoencephalography.

We examined the cortical representation of semantic categorization using magnetic source imaging in a task that revealed both dissociations among superordinate categories and associations among different base-level concepts within these categories. Around 200 ms after stimulus onset, the spatiotemporal correlation of brain activity elicited by base-level concepts was greater within than across superordinate categories in the right temporal lobe. Unsupervised clustering of data showed similar categorization between 210 and 450 ms mainly in the left hemisphere.

Slow event-related brain activity of aphasic patients and controls in word comprehension and rhyming tasks.

Slow event-related potentials (ERP) were examined in healthy and aphasic subjects in two-stimulus designs comprising a word comprehension and a rhyming task. Aphasics, though selected to perform above chance level, made significantly more errors and responded more slowly than controls, although canonical correlations did not indicate a statistical relationship between performance measures and ERP amplitudes. A discriminant analysis of ERP amplitudes distinguished the groups for the slow wave (SW; 0.

Brain activity during syntactic and semantic processing--a magnetoencephalographic study.

Drawings of objects were presented in series of 54 each to 14 German speaking subjects with the tasks to indicate by button presses a) whether the grammatical gender of an object name was masculine ("der") or feminine ("die") and b) whether the depicted object was man-made or nature-made. The magnetoencephalogram (MEG) was recorded with a whole-head neuromagnetometer and task-specific patterns of brain activity were determined in the source space (Minimum Norm Estimates, MNE). A left-temporal focus of activity 150-275 ms after stimulus onset in the gender decision compared to the semantic classification task was discussed as indicating the retrieval of syntactic information, while a more expanded left hemispheric activity in the gender relative to the semantic task 300-625 ms after stimulus onset was discussed as indicating phonological encoding.