How psychiatrists inform themselves and their patients about risks and benefits of antipsychotic treatment Introduction Good information is the basis of good medical decisions (1–3). This means that the quality of doctorsÕ therapeutic decisions is significantly determined by the information available. Only when doctors are informed equally about the benefits and the risks of the treatment options can they make good decisions (4). If doctors predominantly seek information about the advan- tages of a medication and ignore the risks, this might lead to poor decisions. If they predomi- nantly seek information about risks, they may overlook the benefits of a given drug such as its higher efficacy. Numerous studies from the non- medical field (e.g. in the framework of Ôconfir- mation biasÕ and Ôdissonance theoryÕ) show that people frequently tend to inform themselves mainly about the advantages of a preferred decision alternative (5, 6). Mendel R, Hamann J, Traut-Mattausch E, Jonas E, Heres S, Frey D, Kissling W. How psychiatrists inform themselves and their patients about risks and benefits of antipsychotic treatment. Objective: In order to choose the best treatment option, physicians have to inform themselves and their patients about both the benefits and risks of available treatment options equally. Our study aims to investigate whether psychiatrists actually do conduct such a balanced information search and presentation. Method: PsychiatristsÕ information search and information presentation to a patient with schizophrenia were studied using two separate experiments. In both, participants were presented with hypothetical case vignettes and descriptions of fictitious antipsychotics. Results: When searching for information, psychiatrists looked more for risks than benefits of antipsychotic treatment options (t = )3.4, df = 74, P = 0.001). However, when informing a patient, they named more benefits than risks (t = 17.1, df = 224, P < 0.001). Conclusion: The risk-biased information search presumably follows the principle of Ôprimum non nocereÕ. The benefit-biased information presentation might be motivated by the wish to persuade patients to accept the proposed therapy. R. Mendel 1 , J. Hamann 1 , E. Traut-Mattausch 2 , E. Jonas 3 , S. Heres 1 , D. Frey 2 , W. Kissling 1 1 Department of Psychiatry, Technische Universität München, Munich, Germany, 2 Department of Psychology, Ludwig-Maximilians-Universität, Germany and 3 Department of Psychology, Universität Salzburg, Salzburg, Austria Key words: schizophrenia and disorders with psychotic features; physicianÕs practice patterns; decision- making; patient education; bias Rosmarie Mendel, Department of Psychiatry and Psy- chotherapy, Technische Universität München, Mçhlstraße 26, 81675 München, Germany. E-mail: r.mendel@lrz.tum.de Accepted January 16, 2009 Significant outcomes • PsychiatristsÕ information search in the context of antipsychotic drug choice is biased towards information on treatment risks. • PsychiatristsÕ information presentation to patients with schizophrenia is biased towards treatment benefits. Limitations • The experimental setting of the study and lack of ÔgenuineÕ patients. i.e. doctors could act differently in an interaction with real patients. • The sample for the Ôinformation search experimentÕ was different from the sample for the Ôinformation presentation experimentÕ. Acta Psychiatr Scand 2009: 120: 112–119 All rights reserved DOI: 10.1111/j.1600-0447.2009.01357.x Ó 2009 John Wiley & Sons A/S ACTA PSYCHIATRICA SCANDINAVICA 112