Proefschrift

TABLE 3. Likert-scale scores of round 1 criteria. Diagnostic criteria Disagree or strongly disagree Agree or strongly agree Action after analysing the comments A psychiatric diagnosis, as described in the DSM-5, should be established according to applicable guidelines. 13% 83% Accepted During the PAD-procedure the diagnosis must be independently confirmed by at least two psychiatrists. 8% 83% Accepted In addition to the descriptive diagnostics according to the DSM5, it should be standard practice to verify whether there are contextual or systemic factors that cause or maintain the psychiatric complaints. 0% 100% Accepted Broad psycho-diagnostic testing, including personality testing, should be the standard, unless the psychiatrist provides clear reasons why it is not necessary. 36% 41% Rephrased without the words ‘broad’ and ‘standard’ If side effects allow it, the indicated drug-treatments should be adequately performed without leading to a significant reduction in suffering. 0% 98% Accepted If side effects allow it and if indicated, ECT should have been attempted for a sufficient length of time without leading to a significant reduction in suffering. 9% 79% Accepted Psychotherapeutic treatments indicated by the applicable guideline must have been attempted without leading to a significant reduction in suffering. 2% 92% Accepted If necessary, substantial efforts should be made to improve the patient’s social situation without leading to a significant reduction in suffering. 0% 92% Accepted At least one recovery-oriented treatment must have been attempted without this leading to a significant reduction in suffering. 8% 72% Accepted When indicated, psychosurgical treatment (such as DBS) must have been attempted without significantly reducing suffering. 39% 32% Changed ‘attempted’ to ‘offered’ If indicated, at least one acceptanceoriented psychotherapy must have been attempted without leading to a significant reduction in suffering before it can be considered irremediable. 9% 60% Changed ‘before it can be considered irremediable’ to ‘before IPS can be established’ Indicated psychotherapeutic treatments that were ineffective in the past, should be repeated without leading to a significant reduction in suffering. 51% 17% Changed ‘demanded’ to ‘offered’ and added that therapy should only be repeated ‘if there are indications that this is useful’ 106 | PART III - CHAPTER 6 6

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