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Mental capacity in psychiatric patients

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Okai, David, Owen, Gareth, McGuire, Hugh, Singh, Swaran P., Churchill, Rachel and Hotopf, Matthew (2007) Mental capacity in psychiatric patients. British Journal of Psychiatry, Vol.191 . pp. 291-297. doi:10.1192/bjp.bp.106.035162

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Official URL: http://dx.doi.org/10.1192/bjp.bp.106.035162

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Abstract

Background Mental capacity is central to legal and ethical debates on the use of compulsion in psychiatry Aims To describe the clinical epidemiology of mental incapacity in patients with psychiatric disorders, including interrater reliability of assessments, frequency in the psychiatric population and associations of mental incapacity.

Method Cross-sectional studies of capacity to consent to treatment for psychiatric patients were systematically reviewed from Medline, EMBASE and PsycInfo databases. Information on the reliability of assessments, frequency and associations of mental incapacity was extracted.

Results Out of 37 papers reviewed, 29 different capacity assessment tools were identified. Studies were highly heterogeneous in their measurement and definitions of capacity Interrater reliabilities between tools were high. Studies indicate incapacity is common (median 29%) but the majority of psychiatric in-patients are capable of making treatment decisions. Psychosis, severity of symptoms, involuntary admission and treatment refusal were the strongest risk factors for incapacity

Conclusions Mental capacity can be reliably assessed. The majority of psychiatric in-patients have capacity, and socio- demographic variables do not have a major impact but clinical ones do.

Item Type: Journal Item
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
ISSN: 0007-1250
Official Date: October 2007
Dates:
DateEvent
October 2007Published
Volume: Vol.191
Number of Pages: 7
Page Range: pp. 291-297
DOI: 10.1192/bjp.bp.106.035162
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

Data sourced from Thomson Reuters' Web of Knowledge

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