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Limits to truth-telling: neurologists' communication in conversion disorder.
Richard Kanaan1, David Armstrong, Simon Wessely
1King's College London, Department of Psychological Medicine, Institute of Psychiatry, London, UK. r.kanaan@iop.kcl.ac.uk
Patient Education and Counseling
|June 30, 2009
Summary
Neurologists often withhold conversion disorder diagnoses to maintain patient trust, adapting communication based on patient receptivity. This strategy aids therapeutic relationships but may impact diagnostic accuracy.
Area of Science:
- Neurology
- Psychosomatic Medicine
Background:
- Neurologists face a communication dilemma with conversion disorder patients.
- Balancing frankness with therapeutic relationship building is challenging.
Purpose of the Study:
- To explore how UK neurologists manage the disclosure dilemma in conversion disorder cases.
- To understand strategies for effective patient communication in neurology.
Main Methods:
- Qualitative analysis of in-depth interviews.
- Snowball sampling of 22 consultant neurologists in an NHS region.
Main Results:
- Neurologists delayed disclosing conversion disorder until certain.
- Explanations were tailored to patient receptivity; feigning was not discussed.
- Current communication practices were perceived as easier than during training.
Conclusions:
- Neurologists adapt disclosure strategies to patients, improving communication but limiting full truth-telling.
- This adaptive approach can influence diagnostic outcomes.
- Optimizing diagnostic communication requires balancing ethics and therapeutic benefits.
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