HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Owen, A. Search for Related Content PubMed Articles by Owen, A.

Conspiracy of silence?

South Warwickshire Combined Care NHS Trust

Sir: The finding of Clafferty et al (Psychiatric Bulletin, September 2001, 25, 336-339) that only 59% of consultant psychiatrists told people their diagnosis of schizophrenia at the time of the first "established episode" raises a number of interesting issues that deserve further discussion and debate. The conclusion that failure to disclose such a diagnosis constitutes a "conspiracy of silence", contributing to the stigma of mental illness, is highly questionable. Even with operationalised diagnostic criteria, the diagnosis of schizophrenia is often highly unreliable and premature diagnosis may lead to considerable negative effects for the individual concerned and his/her family (McGory, 1995).

The finding that large numbers of consultant psychiatrists use the term psychosis may reflect an increasing trend away from the use of a diagnosis of schizophrenia that has low reliability and questionable validity. There is a growing voice of opinion in favour of the use of the term psychosis, which seems to be meaningful and acceptable to patients (Spencer et al, 2001).

Perhaps there is a need for greater consensus between psychiatrists about how best to give helpful and honest diagnostic information to patients and their families.

References

McGORY, P. D. (1995) Psychoeducation in first episode psychosis: a therapeutic process. Psychiatry, 58, 313-328.[Medline]

SPENCER, E., BIRCHWOOD, M., McGOVERN, D. (2001) Management of first-episode psychosis. Advances in Psychiatric Treatment, 7, 133-142.[Free Full Text]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Owen, A. Search for Related Content PubMed Articles by Owen, A.