Under half of psychiatrists tell patients their diagnosis of Alzheimer’s disease

Editor—Patients are currently requesting more information from their doctors.¹ Patients with Alzheimer’s disease and those who care for them are keen to be given more information about their illness.² The recent development of treatments for patients with the disease has highlighted this issue,³ and therefore the preliminary results of our recent survey of consul- tant psychiatrists working in Scotland is interesting.

We sent a postal questionnaire to all 323 consultant psychiatrists registered with the NHS as working in Scotland in May 1997. Altogether 246 questionnaires (76%) were returned. The questionnaire asked about the doctor’s normal practice in giving information about various psychiatric diagnoses to his or her patients. One section asked if it was the doctor’s normal practice to inform a patient with dementia of his or her diagnosis. Of the doctors who returned the questionnaires, 27 specifically avoided the question on dementia despite answering the other parts of the questionnaire. Of the 209 doctors who did complete this section, only 92 (44%; 95% confidence interval 34% to 54%) stated that it was their normal practice to inform patients with Alzheimer’s disease of their diagnosis. Although some psychiatrists may have thought that this group of patients was not relevant to their clinical practice and therefore did not answer this section, there seems to be a tendency to avoid the question.

The issue of informing patients with Alzheimer’s disease of their diagnosis is difficult and is plagued by ethical issues,⁴ but our results suggest that the normal clinical practice of many psychiatrists does not satisfy the expectations of their patients.