Trends and perspectives of shared decision-making in schizophrenia and related disorders.

PURPOSE OF REVIEW: Shared decision-making (SDM) is a model of how doctors and patients make medical decisions, which is seen as very applicable to mental health. This review addresses the following issues: Do patients and professionals see the need for SDM? Does SDM actually take place for patients with schizophrenia? What are facilitators and barriers of SDM in schizophrenia treatment? What are the outcomes of SDM?

RECENT FINDINGS: Publications in the last 18 months showed the following: Both patients and providers acknowledge the desirability of SDM. SDM occurs less often in mental health than desired by patients and less frequently compared with general practice. SDM in mental health is complex, takes time and involves more than just two participants; patients' lack of decisional capacity is seen as the major barrier. There are only a few interventional studies measuring the outcome of SDM; existing research constantly shows positive, but small effects.

SUMMARY: SDM is highly accepted and wanted in the treatment of schizophrenia and related disorders, but more research is needed regarding how SDM can be implemented in regular care. Healthcare professionals need more training in how to deal with difficult decisional situations.