Should the use of ‘endorse’ be endorsed in writing in psychiatry?

The word “endorse” often appears in the medical literature and is heard in oral presentations; psy­chiatrists use the term to mean that a person is reporting psychiatric symptoms or problems. However, such usage may be a stylistic catachresis—one that has the potential for misinterpretation or misunderstanding.

Finding ‘endorse’ in the psychiatric literature
We conducted a literature search to identify instances of “endorse” in schol­arly articles published in psychiatric journals between January 1, 2012, and November 25, 2013. Table 1^1-14 shows examples of typical uses of “endorse” in recent publications.

Even when “endorse” is used as a syn­onym for “report” or “describe,” use of the word in that context can seem out of place. We could not find any rationale in the medical literature for using “endorse” as a synonym for “report” or “describe.”

The definition of “endorse” in Merriam-Webster¹⁵ and Oxford Dictionaries¹⁶ includes:  
   • inscribing or signing a legal docu­ment, check, or bill  
   • approving or recommending an idea, product, or candidate.

We believe that using “endorse” in a psychiatric context could create confusion among medical trainees and professionals who are familiar with the correct meanings of the word.

Survey: Some residents use ‘endorse’ in oral presentations
We asked residents in the Department of Psychiatry at Drexel University College of Medicine to respond to a questionnaire regarding their understanding of the use of “endorse.” Their responses are summa­rized in Table 2.

What is wrong with using ‘endorse’? Except when “endorse” describes a patient formally affixing her (his) signature to a document for the purpose of (1) certifica­tion or (2) giving or showing one’s support for a cause, we think that use of the word in psychiatry is not in keeping with its formal, accepted definition. Furthermore, residents’ responses to our survey suggest that there is the danger of causing confu­sion in using the word“endorse” when “report” or “describe” is meant.

For example, if a patient “endorses” antisocial behavior, is she stating that she feels justified in exhibiting such behav­ior? Do students who “endorse” drug use approve of drug use? Another example: Youth who “endorse” gang member­ship have merely confirmed that they belonged to a gang at some time.

The intended meaning of “endorse” in these examples is probably closer to “admit” or “acknowledge.” The patient replies “yes” when the physician asks if she uses drugs or has had behavior problems; she is not nec­essarily recommending or approving these behaviors.

Usage is shifting. In the past, “complain” was common medical parlance for a patient’s report of symptoms or other health-related problems. In fact, medical, surgical, and psychiatric evaluations still begin with a “chief complaint” section. It’s possible that, because “complaint” might suggest that the patient is whining, the word fell out of favor in the medical lexicon and was replaced in the scholarly literature by the construction “the patient reports….”

Avoid jargon. Employ accurate terminology
We propose that “endorse,” like “complain,” is a cant of psychiatrists. We recommend that, when describing a patient’s statement or report of symptoms or experiences, prac­titioners should avoid “endorse” and write or say “report,” “express,” “exhibit,” or similar words. Using accurate terminology and avoiding imprecise or misleading jar­gon is not only linguistically appropriate but also can help avoid misunderstanding and improve patient care.

Acknowledgment
Diana Winters, Academic Publishing Services, Drexel University College of Medicine, provided editorial assistance in preparing the manuscript of this article and offered comment on the use of medical jargon.

Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

The word “endorse” often appears in the medical literature and is heard in oral presentations; psy­chiatrists use the term to mean that a person is reporting psychiatric symptoms or problems. However, such usage may be a stylistic catachresis—one that has the potential for misinterpretation or misunderstanding.

Finding ‘endorse’ in the psychiatric literature
We conducted a literature search to identify instances of “endorse” in schol­arly articles published in psychiatric journals between January 1, 2012, and November 25, 2013. Table 1^1-14 shows examples of typical uses of “endorse” in recent publications.

Even when “endorse” is used as a syn­onym for “report” or “describe,” use of the word in that context can seem out of place. We could not find any rationale in the medical literature for using “endorse” as a synonym for “report” or “describe.”

The definition of “endorse” in Merriam-Webster¹⁵ and Oxford Dictionaries¹⁶ includes:  
   • inscribing or signing a legal docu­ment, check, or bill  
   • approving or recommending an idea, product, or candidate.

We believe that using “endorse” in a psychiatric context could create confusion among medical trainees and professionals who are familiar with the correct meanings of the word.

Survey: Some residents use ‘endorse’ in oral presentations
We asked residents in the Department of Psychiatry at Drexel University College of Medicine to respond to a questionnaire regarding their understanding of the use of “endorse.” Their responses are summa­rized in Table 2.

What is wrong with using ‘endorse’? Except when “endorse” describes a patient formally affixing her (his) signature to a document for the purpose of (1) certifica­tion or (2) giving or showing one’s support for a cause, we think that use of the word in psychiatry is not in keeping with its formal, accepted definition. Furthermore, residents’ responses to our survey suggest that there is the danger of causing confu­sion in using the word“endorse” when “report” or “describe” is meant.

For example, if a patient “endorses” antisocial behavior, is she stating that she feels justified in exhibiting such behav­ior? Do students who “endorse” drug use approve of drug use? Another example: Youth who “endorse” gang member­ship have merely confirmed that they belonged to a gang at some time.

The intended meaning of “endorse” in these examples is probably closer to “admit” or “acknowledge.” The patient replies “yes” when the physician asks if she uses drugs or has had behavior problems; she is not nec­essarily recommending or approving these behaviors.

Usage is shifting. In the past, “complain” was common medical parlance for a patient’s report of symptoms or other health-related problems. In fact, medical, surgical, and psychiatric evaluations still begin with a “chief complaint” section. It’s possible that, because “complaint” might suggest that the patient is whining, the word fell out of favor in the medical lexicon and was replaced in the scholarly literature by the construction “the patient reports….”

Avoid jargon. Employ accurate terminology
We propose that “endorse,” like “complain,” is a cant of psychiatrists. We recommend that, when describing a patient’s statement or report of symptoms or experiences, prac­titioners should avoid “endorse” and write or say “report,” “express,” “exhibit,” or similar words. Using accurate terminology and avoiding imprecise or misleading jar­gon is not only linguistically appropriate but also can help avoid misunderstanding and improve patient care.

Acknowledgment
Diana Winters, Academic Publishing Services, Drexel University College of Medicine, provided editorial assistance in preparing the manuscript of this article and offered comment on the use of medical jargon.

Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

The word “endorse” often appears in the medical literature and is heard in oral presentations; psy­chiatrists use the term to mean that a person is reporting psychiatric symptoms or problems. However, such usage may be a stylistic catachresis—one that has the potential for misinterpretation or misunderstanding.

Finding ‘endorse’ in the psychiatric literature
We conducted a literature search to identify instances of “endorse” in schol­arly articles published in psychiatric journals between January 1, 2012, and November 25, 2013. Table 1^1-14 shows examples of typical uses of “endorse” in recent publications.

Even when “endorse” is used as a syn­onym for “report” or “describe,” use of the word in that context can seem out of place. We could not find any rationale in the medical literature for using “endorse” as a synonym for “report” or “describe.”

The definition of “endorse” in Merriam-Webster¹⁵ and Oxford Dictionaries¹⁶ includes:  
   • inscribing or signing a legal docu­ment, check, or bill  
   • approving or recommending an idea, product, or candidate.

We believe that using “endorse” in a psychiatric context could create confusion among medical trainees and professionals who are familiar with the correct meanings of the word.

Survey: Some residents use ‘endorse’ in oral presentations
We asked residents in the Department of Psychiatry at Drexel University College of Medicine to respond to a questionnaire regarding their understanding of the use of “endorse.” Their responses are summa­rized in Table 2.

What is wrong with using ‘endorse’? Except when “endorse” describes a patient formally affixing her (his) signature to a document for the purpose of (1) certifica­tion or (2) giving or showing one’s support for a cause, we think that use of the word in psychiatry is not in keeping with its formal, accepted definition. Furthermore, residents’ responses to our survey suggest that there is the danger of causing confu­sion in using the word“endorse” when “report” or “describe” is meant.

For example, if a patient “endorses” antisocial behavior, is she stating that she feels justified in exhibiting such behav­ior? Do students who “endorse” drug use approve of drug use? Another example: Youth who “endorse” gang member­ship have merely confirmed that they belonged to a gang at some time.

The intended meaning of “endorse” in these examples is probably closer to “admit” or “acknowledge.” The patient replies “yes” when the physician asks if she uses drugs or has had behavior problems; she is not nec­essarily recommending or approving these behaviors.

Usage is shifting. In the past, “complain” was common medical parlance for a patient’s report of symptoms or other health-related problems. In fact, medical, surgical, and psychiatric evaluations still begin with a “chief complaint” section. It’s possible that, because “complaint” might suggest that the patient is whining, the word fell out of favor in the medical lexicon and was replaced in the scholarly literature by the construction “the patient reports….”

Avoid jargon. Employ accurate terminology
We propose that “endorse,” like “complain,” is a cant of psychiatrists. We recommend that, when describing a patient’s statement or report of symptoms or experiences, prac­titioners should avoid “endorse” and write or say “report,” “express,” “exhibit,” or similar words. Using accurate terminology and avoiding imprecise or misleading jar­gon is not only linguistically appropriate but also can help avoid misunderstanding and improve patient care.

Acknowledgment
Diana Winters, Academic Publishing Services, Drexel University College of Medicine, provided editorial assistance in preparing the manuscript of this article and offered comment on the use of medical jargon.

Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.