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9 J. Forensic Psychiatry & Psych. 1 (1998)

handle is hein.journals/jnlofncpy9 and id is 1 raw text is: 






EDITORIALS


    Feedback for the personality

                       disordered


                       PETER TYRER



Four years ago I was seeing a depressed patient who had also been involved
in a serious motor accident in which he had been injured. During the course
of my assessment, which always includes a review of personality status, I con-
cluded that he had a paranoid personality disorder. I mentioned this in my
letter to the GP but did not give any information about this to the patient. I
tried hard to get a good relationship with him and felt that I made some
progress in that he no longer grilled me on issues of confidentiality after I had
seen him for around 9 months. Unfortunately a year later his notes were
requisitioned by his solicitors in connection with a claim over the suffering
created by his accident. The offending letter describing his personality dis-
order diagnosis was shown to the patient and he responded in a way that con-
firmed the diagnosis. He refused to have anything more to do with me and
extended this refusal to include any organization that had any contact with
me. As a consequence he is now still suffering from depression (I think) but
has no contact with any mental health professional, including a GP (as they
too have been contaminated by association with me).
  Before this time I had always tried my best to feed back diagnostic infor-
mation to my patients but had not extended this to telling them about my
assessment of their personality status. However, since my experience with
this depressed man and with the increased emphasis on collaboration and
'user involvement' in all aspects of clinical care, I have now taken the plunge
and fed back even this information to my patients (including those with para-
noid personality disorder).
  The response has been generally favourable and this to some extent has


The Journal of Forensic Psychiatry Vol 9 No 1 May 1998 1-4
© Routledge 1998


ISSN 0958-5184