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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

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