Mental capacity and consent to treatment in psychiatric patients: the state of the research
Abstract
PURPOSE OF REVIEW: The past three decades have seen the emergence of the field of decision-making capacity research. The growth has been such that there are several reviews covering a variety of subtopics within the field. The goal is to briefly summarize the state of research. RECENT FINDINGS: Most studies in this field use the MacArthur Competence Assessment Tools for the decisional capacity assessment. Studies in psychiatric patients indicate incapacity is common (20-30%), but the majority are capable of making treatment decisions. Positive symptoms (hallucinations, delusions); negative symptoms (unusual thought content, conceptual disorganization); severity of symptoms; involuntary admission; lack of insight and treatment refusal were the stronger predictors for incapacity in acute and cognitive dysfunction in chronic patients. SUMMARY: Mental capacity has complex relationships with psychopathological variables, and these relationships are different according to diagnostic group. More research is needed to determine the clinical parameters related to the lack of capacity to make treatment decisions in psychiatric patients.
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One study using the McArthur Competence Assessment Tool for Treatment established that 70% to 80% of involuntarily hospitalised patients with mental illness are capable with respect to treatment decisions.
“One study using the most well-validated standardised capacity assessment tool, the McArthur Competence Assessment Tool for Treatment (McCAT-T), established that 70% to 80% of involuntarily hospitalised patients with mental illness are capable with respect to treatment decisions.”
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- Authors
- Candia, P. C., & Barba, A. C.
- Affiliations
- Hospital General Universitario Gregorio Marañón (ES)
- Corresponding author
- Candia, Paola C.
- ORCID
- Barba, Alfredo C.
- Venue
- Current Opinion in Psychiatry
- Published
- 2011-09
- Volume
- 24
- Issue
- 5
- Pages
- 442-446
- ISSN
- 0951-7367 (ISSN-L)
- OpenAlex
- W2315379505
- Cited by
- 38
- References
- 40
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 6 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 1
- FWCI
- 0.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in 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 › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Keywords
- decision-making capacity, consent to treatment, psychiatric patients, treatment refusal, lack of insight, positive symptoms, negative symptoms, cognitive impairment, involuntary admission
- MeSH terms
- Mental Disorders, Humans, Informed Consent, Research, Mental Competency
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