Guiding principles

The general principles noted below apply to all reports, whether the psychiatrist knows the patient because of current or previous clinical responsibility, or whether the report is on a patient whom the psychiatrist has not seen before (this latter is known as providing an 'expert opinion').


In most situations written consent must be obtained from the patient before personal information can be given to an outside agency. In almost all situations involving the writing of a report on an individual to an outside agency, that individual will gain sight of the report or will be entitled to do so. It is therefore good clinical practice for the patient to be aware of the content of the report, and particularly of any opinions or recommendations it may contain. Nevertheless, there are certain situations where the duty of care to the public or to a child overrides the duty of confidentiality, and in such circumstances the psychiatrist may write the report even without the patient's consent.


The opinion of the psychiatrist is being sought as an expert professional. The report should not be biased in favour of one side or another and should not be influenced unduly by the interests of the commissioning agency or the psychiatrist's view of the best interests of their patient. This may cause difficulties if the patient is in the personal care of the psychiatrist because in most clinical situations psychiatrists try to be non-critical, non-judgemental, and supportive, tending to encourage rather than to prevent. But the best interests of the patient will not be served by being put in a situation where the likely outcomes are failure to do what is expected or to function at a suboptimal level.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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