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Neuropsychiatr Dis Treat. 2013;9:1045-52. doi: 10.2147/NDT.S49021. Epub 2013 Jul 30.

Shared decision making in psychiatric practice and the primary care setting is unique, as measured using a 9-item Shared Decision Making Questionnaire (SDM-Q-9).

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Department of Psychiatry, University of La Laguna, Tenerife, Spain ; Health Services Research Network for Chronic Diseases (REDISSEC), Tenerife, Spain.



To measure and compare the extent to which shared a decision making (SDM) process is implemented both in psychiatric outpatient clinical encounters and in the primary care setting from the patient's perspective.


A total of 1,477 patients recruited from the Canary Islands Health Service mental health and primary care departments were invited to complete the nine-item Shared Decision Making Questionnaire (SDM-Q-9) immediately after their consultation. MANCOVA, Student's t-test, and Pearson correlations were used to assess the relationship and differences between SDM-Q-9 scores in patient samples.


No differences were found in SDM-Q-9 total scores between the two patient samples, but there were relevant differences when item by item analysis was applied; differences were observed according to the different steps of the SDM process. SDM is present to a very limited extent in the routine psychiatric setting compared to primary care. Patients' age, education, type of appointment, and treatment decision all play a specific role in predicting SDM.


The study provides evidence that SDM is a complex process that needs to be analyzed according to its different steps. SDM patterns were different in the primary care and psychiatric outpatient care settings and reflect quite a different perspective of the decision making process.


SDM-Q-9; primary care patients; psychiatric outpatients; shared decision making

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