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Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries

Kuzman, Martina Rojnic; Slade, Mike; Puschner, Bernd; Scanferla, Elisabetta; Bajic, Zarko; Courtet, Philippe; Samochowiec, Jerzy; Arango, Celso; Vahip, Simavi; Taube, Maris; Falkai, Peter; Dom, Geert; Izakova, Lubomira; Carpiniello, Bernardo; Bellani, Marcella; Fiorillo, Andrea; Skugarevsky, Oleg; Mihaljevic-Peles, Alma; Telles-Correia, Diogo; Novais, Filipa; Mohr, Pavel; Wancata, Johannes; Hultén, Martin; Chkonia, Eka; Balazs, Judit; Beezhold, Julian; Lien, Lars; Mihajlovic, Goran; Delic, Mirjana; Stoppe, Gabriela; Racetovic, Goran; Babic, Dragan; Mazaliauskiene, Ramune; Cozman, Doina; Hjerrild, Simon; Chihai, Jana; Flannery, William; Melartin, Tarja; Maruta, Nataliya; Soghoyan, Armen; Gorwood, Philip

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Martina Rojnic Kuzman

Professor of Mental Health Recovery and Social Inclusion

Bernd Puschner

Elisabetta Scanferla

Zarko Bajic

Philippe Courtet

Jerzy Samochowiec

Celso Arango

Simavi Vahip

Maris Taube

Peter Falkai

Geert Dom

Lubomira Izakova

Bernardo Carpiniello

Marcella Bellani

Andrea Fiorillo

Oleg Skugarevsky

Alma Mihaljevic-Peles

Diogo Telles-Correia

Filipa Novais

Pavel Mohr

Johannes Wancata

Martin Hultén

Eka Chkonia

Judit Balazs

Julian Beezhold

Lars Lien

Goran Mihajlovic

Mirjana Delic

Gabriela Stoppe

Goran Racetovic

Dragan Babic

Ramune Mazaliauskiene

Doina Cozman

Simon Hjerrild

Jana Chihai

William Flannery

Tarja Melartin

Nataliya Maruta

Armen Soghoyan

Philip Gorwood


While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe.

We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style – Staff questionnaire and a set of questions regarding clinicians’ expertise, training, and practice.

SDM was the preferred decision-making style across all European regions ([central and eastern Europe, CEE], northern and western Europe [NWE], and southern Europe [SE]), with an average of 73% of clinical decisions being rated as SDM. However, we found significant differences in non-SDM decision-making styles: participants working in NWE countries more often prefer shared and active decision-making styles rather than passive styles when compared to other European regions, especially to the CEE. Additionally, psychiatry specialist trainees (compared to psychiatrists), those working mainly with outpatients (compared to those working mainly with inpatients) and those working in community mental health services/public services (compared to mixed and private settings) have a significantly lower preference for passive decision-making style.

The preferences for SDM styles among European psychiatrists are generally similar. However, the identified differences in the preferences for non-SDM styles across the regions call for more dialogue and educational efforts to harmonize practice across Europe.


Kuzman, M. R., Slade, M., Puschner, B., Scanferla, E., Bajic, Z., Courtet, P., …Gorwood, P. (2022). Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries. European Psychiatry, 65(1), Article e75.

Journal Article Type Article
Acceptance Date Sep 21, 2022
Online Publication Date Oct 21, 2022
Publication Date 2022
Deposit Date Oct 24, 2022
Publicly Available Date Oct 24, 2022
Journal European Psychiatry
Print ISSN 0924-9338
Electronic ISSN 1778-3585
Publisher Royal College of Psychiatrists
Peer Reviewed Peer Reviewed
Volume 65
Issue 1
Article Number e75
Keywords Psychiatry and Mental health
Public URL
Publisher URL


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