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Cited by 16Healthcare Decision-Making and RestraintsEthics and bioethics in healthcareEthics in Clinical Research

Do psychiatric patients improve their competency to consent to hospitalization after admission? A prospective study in an acute inpatient ward

Fraguas, David, García-Solano, Fernando, Chapela, Esther, Terán, Sara, de la Peña, Juan José, Calcedo-Barba, Alfredo·2007·General Hospital Psychiatry
DOI 10.1016/j.genhosppsych.2006.09.005
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Abstract

Objectives Competency to consent to hospitalization has important clinical and ethical implications. However, there are no follow-up studies that evaluate improvement in competency during psychiatric hospitalization. The authors sought to determine whether patients admitted to a psychiatric ward as incompetent to consent to hospitalization improve their competency during hospitalization.Method A total of 160 consecutively admitted patients were administered the Competency Questionnaire (CQ), a structured scale designed to assess competency to consent to psychiatric hospitalization. The CQ was administered both upon admission and at discharge. Severity and acuity of the psychiatric disorder were assessed with the Severity of Psychiatric Illness Scale and the Acuity of Psychiatric Illness Scale.Results Of the 160 assessed patients, 70 (43.8%) were rated incompetent. Forty-five of these 70 incompetent patients completed the admission-to-discharge follow-up. Twenty-one of these 45 patients (46.6%) remained incompetent at discharge. Participation in the treatment process was the only variable that predicted improvement on competency during hospitalization. Severity of psychiatric illness at admission did not predict improvement on competency.Conclusions Nearly half of the patients who upon admission were incompetent remained incompetent at discharge.

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Crossref · 10.1016/j.genhosppsych.2006.09.005

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  • At least 48% of psychiatric patients have the capacity to decide on hospitalization at the time of admission.

    “Tentatively, it could be said that at least 48% of psychiatric patients do have the capacity to decide on hospitalization at the time of admission (Di & Cheng, 2013;Fraguas et al., 2007;Seo et al., 2011)”

    From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Fraguas et al., 2007

  • In one study, the proportion of 160 patients who lacked capacity decreased from 24.3% at admission to 5.4% at follow up.

    “In one study, the proportion of 160 patients who lacked capacity decreased from 24.3% (95% CI [12 -41%]) at admission to just 5.4% (95% CI [0 -2%]) at follow up (Fraguas et al., 2007).”

    From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Fraguas et al., 2007

  • Patients who had longer hospital admissions were more likely to lack capacity.

    “Finally, patients who had longer hospital admissions were more likely to lack capacity (Chiu et al., 2014;Fraguas et al., 2007).”

    From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Fraguas et al., 2007

  • Schizophrenia was the psychiatric diagnosis associated with the highest rate of incapacity in six studies.

    “Schizophrenia was the psychiatric diagnosis associated with the highest rate of incapacity in six studies (Curley, Murphy, Plunkett, et al., 2019c;Fraguas et al., 2007;Mandarelli et al., 2018b;G. Owen et al., 2009;G. S. Owen et al., 2011;Tor et al., 2020)”

    From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Fraguas et al., 2007

  • Positive symptoms were found to be associated with incapacity in 8 studies, especially conceptual disorganization, manic symptoms, delusions and unusual thought content.

    “Positive symptoms were found to be associated with incapacity in 8 studies (Dornan et al., 2015;Fraguas et al., 2007;Kennedy et al., 2009;Mandarelli et al., 2018b;G. Owen et al., 2009;Skipworth et al., 2013;Spencer et al., 2018), especially conceptual disorganization (G.Owen et al., 2009;Skipworth et al., 2013), manic symptoms (Mandarelli et al., 2014(Mandarelli et al., , 2018b;;Spencer et al., 2”

    From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Fraguas et al., 2007

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Authors
Fraguas, D., García-Solano, F., Chapela, E., Terán, S., de la Peña, J. J., & Calcedo-Barba, A.
Affiliations
Hospital General Universitario Gregorio Marañón (ES)
Corresponding author
Fraguas, David
ORCID
Fraguas, David
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
2007-01
Volume
29
Issue
1
Pages
54-62
ISSN
0163-8343 (ISSN-L)
DOI
10.1016/j.genhosppsych.2006.09.005
OpenAlex
W2132944484
Cited by
16
References
20
Citations by year
2024: 1 · 2023: 1 · 2021: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 2
FWCI
1.10
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • General Hospital Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
Keywords
capacity to consent, psychiatric hospitalization, acute psychiatric inpatients, treatment participation, disease severity, informed consent
MeSH terms
Acute Disease, Adult, Mental Disorders, Cognition Disorders, Female, Hospitalization, Humans, Informed Consent, Male, Middle Aged, Patient Admission, Prospective Studies, Surveys and Questionnaires, Mental Competency

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