A comparison of patients' and prescribers' beliefs about neuroleptic side‐effects: prevalence, distress and causation

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Abstract
Neuroleptic side‐effects adversely affect clinical outcome in schizophrenic patients. Clinicians therefore require an understanding of the impact of such side‐effects. This study compared psychiatrists’ estimates of the prevalence of neuroleptic side‐effects and associated distress with schizophrenic patients’ reports of side‐effects and distress. Psychiatrists were asked to estimate the likelihood of informing patients about side‐effects. Psychiatrists’ estimates of prevalence but not of distress correlated significantly with patients’ reports. Psychiatrists’ avowed decisions to inform patients about side‐effects were significantly correlated with their estimates of prevalence and distress, but not with patients’ reported levels of distress. Patients were unlikely to attribute side‐effects to neuroleptic medication. These results indicate that patients and psychiatrists share similar views about the prevalence and implications of neuroleptic side‐effects. However, psychiatrists’ apparent lack of understanding of which side‐effects are most likely to cause distress to patients may adversely affect the therapeutic alliance between prescribers and consumers.