Rosenhan (1973)

Question 1

What is the summary of Rosenhan (1973)? (goal, procedure, admission, findings)

Answer 1

• Rosenhan wanted to see whether or not hospital psychiatrists could distinguish the sane from the insane.
• He sent 8 confederate pseudo patients to 12 hospitals in the US to fake one symptom of schizophrenia (hearing noises).
• They were all admitted into the hospitals with schizophrenia, except one, who was admitted with manic depression with psychosis.
• Rosenhan found that staff pathologised normal behaviour, like interpreting pacing in the corridors due to boredom as nervousness.

Question 2

What was the aim?

Answer 2

To see whether or not hospital psychiatrists could distinguish the sane from the insane.

Question 3

What was the procedure? (sample, admission, symptoms)

Answer 3

• 8 confederate pseudo patients.
• 12 hospitals in the US (old/new, good/bad, public/private).
• All pseudo patients claimed that they were hearing voices.
• All admitted into the hospitals with schizophrenia, except one, who was admitted with manic depression with psychosis.
• After they were admitted, they stopped faking symptoms in order to try and get out.

Question 4

What were the findings? (diagnoses, stay, staff)

Answer 4

• All pseudo patients were diagnosed with a serious mental disorder despite showing minimal symptoms.
• The staff never suspected that they were sane, and simply dismissed them with schizophrenia in remission (a rare condition where you no longer show signs of schizophrenia).
• The average stay in the hospital was 19 days, the shortest was 7, and the longest was 52.
• Other patients suspected they were sane. 1/3 of the patients challenged pseudo patients in three hospitals.
• Staff pathologised normal behaviour, like interpreting pacing in the corridors due to boredom as nervousness, and waiting for lunch early as ‘Oral-inquisitive syndrome’.

Question 5

What were the conclusions?

Answer 5

‘We cannot distinguish the sane from the insane in psychiatric hospitals’ - Rosenhan

Over-diagnosis occurs because clinicians avoided mentally ill people.

Question 6

What was Rosenhan’s follow-up study?

Answer 6

• Some institutions challenged the results of Rosenhan’s study.
• Rosenhan decided to conduct a similar study.
• Hospitals claimed they caught 41 patients, thought to be fake by at least one staff member, and 19 of those were classed as fake by two members.
• Rosenhan sent no pseudo patients to the hospital, confirming the unreliability of the diagnostic process. He fooled them.