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Aims & MethodTo investigate patients' views on receiving copies of letters sent by their healthcare professionals, 72 patients were asked about their willingness to receive a copy of the letter sent to their general practitioner and about preferences for the type of information to be included in such letters. We also asked what concerns, if any, they had about the process.ResultsThree-quarters of the respondents (n=55) said they would like to receive a copy of the letter. Patients accepted the inclusion of information about their illness but were reluctant for data about their family, work and finances to be included.Clinical ImplicationsAlthough the majority of the patients we interviewed wished to have the copy letter, many of them expressed concerns about confidentiality, the risk of distress and the cost of the process to the National Health Service. The rights of those who do not want copy letters should also be respected.

We conclude that although many patients would like to know the truth, the rights of those who do not wish to know should also be respected. Therefore the diagnosis of mental disorder should not be routinely disclosed, but mental health professionals should take into consideration their patients' preferences and act appropriately to their choice. (Int J Psych Clin Pract 2002; 6: 103-106).

The boundary between spiritual experience and mental disorder remains unclear and should invite collaboration between psychiatry and other disciplines, including theology. Jackson and Fulford (1997), using the tools of analytic philosophy, have proposed a model allowing principled differentiation between spiritual experience and psychotic symptoms based on the personal values of the subject, a cognitive problem-solving model. Spiritual experience is described as positively evaluated psychotic experience, which enables the subject to do more than he or she normally does. In the present paper, it is claimed that values and actions cannot alone always discriminate between religious experience and psychopathology. With reference to three case studies, drawn from the practice of one of us, it is argued that spirituality is not all about experience and that it cannot be understood without reference to the subject's personal history and spiritual tradition, however implicit or fragmented. This approach would allow an account of ordinary religious experience in those who have suffered ego disablement during mental illness. Drawing primarily on the Christian tradition, we argue that the use of theological criteria may allow levels of discrimination between spiritual experience and mental disorder not allowed for by philosophical psychopathology.