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Mental capacity in psychiatric patients : systematic review
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Okai, David, Owen, Gareth S., McGuire, H. (Hugh), Singh, Swaran P., Churchill, Rachel and Hotopf, Matthew (2007) Mental capacity in psychiatric patients : systematic review. The British Journal of Psychiatry, Volume 191 (Number 4). pp. 291-297. doi:10.1192/bjp.bp.106.035162 ISSN 0007-1250.
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Official URL: http://dx.doi.org/10.1192/bjp.bp.106.035162
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 Article | ||||
|---|---|---|---|---|---|
| Subjects: | K Law [Moys] > KN Common Law, Private Law R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||
| Library of Congress Subject Headings (LCSH): | Psychotherapy patients -- Medical care, Mental health laws -- Great Britain, Systematic reviews (Medical research), Capacity and disability | ||||
| Journal or Publication Title: | The British Journal of Psychiatry | ||||
| Publisher: | Royal College of Psychiatrists | ||||
| ISSN: | 0007-1250 | ||||
| Official Date: | 2007 | ||||
| Dates: |
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| Volume: | Volume 191 | ||||
| Number: | Number 4 | ||||
| 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 | ||||
| Funder: | Great Britain. Department of Health (DoH) |
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