There has been little research into psychiatric patients’ preferences in beginning their interaction with a psychiatrist. In general, doctors and medical students are encouraged to shake hands with the patient, address them by name and introduce themselves. A survey on patient expectations for greetings has been reported by Makoul et al. ^{Reference Makoul, Zick and Green1} We present here a similar survey involving psychiatric out-patients.

We invited individuals attending out-patient appointments in adult and old age clinics to fill in a tick-box questionnaire comprising four questions about specific greeting behaviours.

1. 1. Would you prefer to be addressed by your first name, last name or it does not matter?

2. 2. Would you prefer the doctor to shake your hand or not?

3. 3. Should doctors introduce themselves using their first name, last name, both names, and/or as a doctor?

4. 4. Would you want the doctor to explain their role in your healthcare?

All responses were analysed for content.

Overall, 98 responses were obtained at the end of a month, 70 from the under-65 age group (range 19–64 years old, mean age 44.3 years) and 28 from the over-65 group (range 65–94 years old, mean age 76 years); 50% of responders under 65-years-old and 64% of over 65-years-old were female.

On the question of how the person prefers to be addressed, 91% wanted their first name to be used when greeted, the figures being similar for older and younger patients; 20 did not comment. With regard to shaking hands, 86% wanted the physician to shake their hand during the greeting, with a stronger preference among older people; 44 did not comment. Further, the majority (68%) preferred the doctor to introduce themselves as a doctor and with their first and last name; 21 did not comment. Almost all respondents (98%) wanted an explanation of the doctor's role in healthcare; 17 did not comment.

The figures in our study are similar to those found by Makoul et al ^{Reference Makoul, Zick and Green1} and show that psychiatric out-patients wish to be treated similarly to those attending any other general medical clinic. However, the stigma and potential dangerousness of encounters with psychiatric patients may prevent doctors from treating them so and needs to be addressed in training.

Psychiatric interviews involve a potentially intense emotional experience. With respect to shaking hands, the importance of being sensitive to non-verbal cues is paramount. At least at first contact, we must use patients’ first and last names to assure identification and perhaps subsequently ask about patients’ preferred from of address. A comfortable form of introduction for doctors would be to introduce themselves fully at least the first time. Explaining our role is an essential component of introduction, and avoids patient confusion and anxiety at the outset. All of the above may vary depending on culture and ethnicity, and perhaps the different circumstances when we interview patients. However, greetings constitute an important part of establishing the therapeutic relationship with patients and as such need appropriate attention.