ArticleBMJ open2017
Cross-sectional survey on defensive practices and defensive behaviours among Israeli psychiatrists.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07405411 (The Prevalence, Causes, and Prevention Strategies of Medical Malpractice in Psychiatric Clinics), which is not on this map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Prevalence, Causes, and Prevention Strategies of Medical Malpractice in Psychiatric Clinics: A Descriptive and Correlational Study
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Thematic mapping of off-label prescription in psychiatry and its implications for bioethics, human rights, and clinical practice: a scoping review.Frontiers in psychiatry · 2026Pooled it
- How defensive medicine is defined in European medical literature: a systematic review.BMJ open · 2022Pooled it
- Defensive Medical Practice in Dentistry: A Dual-Perspective Cross-Sectional Analysis of Dentists and Patients in Romania.Healthcare (Basel, Switzerland) · 2026Article
- Defensive medicine-related practices among child and adolescent psychiatrists in Türkiye: prevalence, behavioral patterns, and associated factors.Frontiers in psychiatry · 2026Article
- Suicide Risk Assessments Understood as Medical Rituals: Functions and Implications from Societal and Medico-Ethical Perspectives.Journal of bioethical inquiry · 2025Article
- From challenge to growth: Exploring physician narratives of patient complaints during residency.Medical education · 2025Review
- Prevalence of defensive medicine behaviors, associated risk factors and its mitigation strategies among physicians in Gaza Strip, palestine: a mixed method study.BMC medical ethics · 2025Article
- Examining the role of psychiatrists in involuntary admissions under the Mental Health Act in New Zealand.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2025Article
- Exploring the impact of workplace violence on defensive medicine and patient outcomes: an empirical analysis using regression discontinuity.BMC health services research · 2025Article
- Evaluation of dentists' malpractice fears and defensive dentistry attitudes: a scale development.BMC oral health · 2025Article
- Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Notes on psychiatrist liability around the world regarding suicide.Frontiers in psychiatry · 2024Review
- Defensive medicine practices as a result of malpractice claims and workplace physical violence: a cross-sectional study from Egypt.Scientific reports · 2023Article
- Predictors of Defensive Practices among Italian Psychiatrists: Additional Findings from a National Survey.Medicina (Kaunas, Lithuania) · 2023Article
- Psychiatrists' occupational stigma conceptualization, measurement, and intervention: A literature review.World journal of psychiatry · 2023Review
- Collateral Victims of Defensive Medical Practice.Healthcare (Basel, Switzerland) · 2023Article
- Article
- The occurrence, types, reasons, and mitigation strategies of defensive medicine among physicians: a scoping review.BMC health services research · 2022Article
- Iatrogenic Complications of Compulsory Treatment in a Patient Presenting with an Emotionally Unstable Personality Disorder and Self-Harm.Case reports in psychiatry · 2021Article
- Defensive practice is indefensible: how defensive medicine runs counter to the ethical and professional obligations of clinicians.Medicine, health care, and philosophy · 2020Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePsychiatry is a low-risk specialisation; however, there is a steady increase in malpractice claims against psychiatrists. Defensive psychiatry (DP) refers to any action undertaken by a psychiatrist to avoid malpractice liability that is not for the sole benefit of the patient's mental health and well-being. The objectives of this study were to assess the scope of DP practised by psychiatrists and to understand whether awareness of DP correlated with defensive behaviours.
methodsA questionnaire was administered to 213 Israeli psychiatry residents and certified psychiatrists during May and June 2015 regarding demographic data and experience with malpractice claims, medicolegal literature and litigation. Four clinical scenarios represented defensive behaviours and reactions (feelings and actions) to malpractice claims.
resultsForty-four (20.6%) certified psychiatrists and four (1.9%) residents were directly involved in malpractice claims, while 132 (62.1%) participants admitted to practising DP. Residents acknowledged the practice of DP more than did senior psychiatrists (p=0.038).Awareness of DP correlated with unnecessary hospitalisation of suicidal patients, increased unnecessary follow-up visits and prescribing smaller drug dosages than required for pregnant women and elderly patients.
conclusionsThis study provides evidence that DP is well established in the routine clinical daily practice of psychiatrists. Further studies are needed to reveal whether DP effectively protects psychiatrists from malpractice suits or, rather, if it impedes providing quality psychiatric care and represents an economic burden that leads to more harm for the patient.
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