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What is going on when a psychiatric patient claims a psychiatric diagnosis for themselves which is different from the one a practitioner is investigating? We analyze cases from 10 interviews between psychiatric patients and a nurse using a formal interview schedule to assess whether the patient has a personality disorder. When the patient invokes (temporary) depression to explain some of their experiences or life circumstances, the nurse then has to handle that, while dispassionately pursuing an interview schedule that is, on the contrary, predicated on the diagnosis being a long-term personality disorder. We show how the nurse balances respect for the patient’s account while also performing her institutional duties. The data are in Finnish.

How to respond when patients invoke a diagnosis for themselves: Evidence from a nurse’s response practices in personality disorder interviews