a) Behaviour not noted by the three professionals during Analysis 2 (we subsequently added them)b) Behaviour that was focused on during Analysis 2 but for which the three professionals’ interpretations were differentThe patient was informed of their diagnosis four days before the event. The patient struggled to come to terms with the diagnosis, saying that they were in a state of shock and wanted to find a way to ease it. The patient had never been admitted to a psychiatric hospital before and experienced anxiety and dread in the new environment.Deemed a suicide risk, the patient was transferred to a closed ward. Although this was necessary, the new environment caused the patient’s psychotic symptoms to worsen.The patient’s dose was decreased because of side-effects. Consequently, the patient experienced anxiety and irritability, symptoms that were suppressed by the medicine or withdrawal symptoms.Following the first session of ECT after resuming therapy, the patient exhibited lively behaviour that was incongruous with their behaviour theretofore. For example, after drinking something, the patient gleefully declared that the drink was delicious. They also purchased a sports drink and consumed 90% of a curry. b)The family informed the staff that the patient had thought about suicide.On the day of the event, the family informed the staff that the patient was crying after their meeting. A nurse visited the patient’s room, and the patient lamented that their hopes of discharge had been dashed.The family informed the staff about the patient’s suicidal ideation. However, the staff neglected to discuss this with the patient.What the patient talked about and how they behaved varied between the principal doctor and nurses. In the presence of the principal doctor, the patient tried to give the impression that they were getting better. In contrast, with the nurses, the patient complained of anxiety and anxiety-induced somatic conditions.The family said that they would not allow the patient to return to the family home after discharge. 266kill themselves.The third major category, ‘signs from response to treatment’, contained four sub-categories. [Response to learning of diagnosis] described cases in which the patient had just learned of their diag-nosis and struggled to come to terms with it; [response to clinical environment] described responses to being admitted to hospital or being transferred to a closed ward; [response to dosage change] described symptoms associated with a reduction in the dosage following an adverse reac-tion. The fourth sub-category, [unnatural clinical response], described a case in which a patient who had discontinued electroconvulsive therapy (ECT) exhibited, upon resuming ECT, animated behaviour that was incongruous with their behaviour thereto-fore.The fourth category, ‘signs associated with reports from the family’, contained two sub-catego-Signs from response to treatmentResponse to learning of diagnosisResponse to clinical environmentResponse to dosage changeUnnatural clinical responseReports from the familySigns associated with reports from the familyFamily report not discussedAttitude inferred from integrated informationSigns inferred from multiple sources of information Situational inferencesResponse to admissionResponse to ward transferReport on suicidal ideationInformation provided during the meetingTries to please the principal doctorIsolationries. The first, [reports from the family], included
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