Mental capacity to consent to treatment in anorexia nervosa: explorative study
Open accessAbstract
BACKGROUND: Mental capacity to consent to treatment in anorexia nervosa is a neglected area in clinical decision-making. AIMS: To examine clinical and neuropsychological parameters associated with diminished mental capacity in anorexia nervosa. METHOD: An explorative study was conducted in 70 adult female patients with severe anorexia nervosa. Mental capacity to consent to treatment was assessed by experienced psychiatrists. Further measurements included the MacCAT-T (to assess mental capacity status), a range of clinical measures (body mass index (BMI) and comorbidity) and neuropsychological tests assessing decision-making, central coherence and set-shifting capacity. RESULTS: Diminished mental capacity occurs in a third of patients with severe anorexia nervosa and is associated with a low BMI, less appreciation of illness and treatment, previous treatment for anorexia nervosa, low social functioning and poor set shifting. CONCLUSIONS: Assessment of diminished mental capacity in anorexia nervosa requires careful evaluation of not only BMI, but also the degree of appreciation of illness and treatment, history and the tendency to have a rigid thinking style. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Literature suggests that capacity impairments can be subtle in eating disorders.
“While clinical rationales asserted that patients were capable of making a life-ending decision and that their desire to die was not influenced by symptoms of mental illness, literature suggests that capacity impairments can be subtle in EDs (42, 150).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [150]
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References 49 · Cited by 54
Research works printed but not linked: 2
- [29]American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Test Revision) (DSM-IV-TR). APA, 2000.
- [32]First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders. American Psychiatric Press, 1996.
- Authors
- Elzakkers, I. F. F. M., Danner, U. N., Hoek, H. W., & van Elburg, A. A.
- Affiliations
- Altrecht GGZ (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Elzakkers, Isis F.F.M.
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-03
- Volume
- 2
- Issue
- 2
- Pages
- 147-153
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC4998943
- OpenAlex
- W2302894204
- Cited by
- 54
- References
- 49
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 8 · 2020: 17 · 2019: 1 · 2018: 2 · 2017: 1
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BJPsych Open (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc-nd)
- Utrecht University Repository (Utrecht University) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Keywords
- anorexia nervosa, diminished mental capacity, informed consent, treatment decision-making, neuropsychological assessment, decision-making, central coherence, set-shifting, illness perception, body mass index, social functioning, comorbidities
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