Competence to give informed consent in acute psychosis is associated with symptoms rather than diagnosis

Received 3 June 2004; received in revised form 1 March 2005; accepted 4 March 2005.

Abstract

To investigate the association between competence to give informed consent to treatment, specific symptomology and diagnostic category, 110 inpatients diagnosed with DSM-IV acute schizophrenia (n=64), schizoaffective disorder (n=25) and bipolar affective disorder (n=21) were interviewed using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) and the Positive and Negative Syndrome Scale (PANSS). Results indicated no significant difference in competence between the three disorders. Elevated positive, cognitive and excitement PANSS factor scores had lower MacCAT-T scores. Further analyses indicated symptoms that impair cognition; particularly, conceptual disorganisation and poor attention were most consistently related to poor performance on competence tests.

Keywords: Competence, Psychosis, MacArthur Competence Assessment Tool for Treatment

a Mental Health Research Institute, Locked Bag 11, Parkville, Victoria, 3052, Australia

b Alfred Hospital, P.O. Box 315 Prahran, Victoria, 3181, Australia

c Melbourne Law School, Level 9, The University of Melbourne, Victoria 3010, Australia

d Department Psychological Medicine, Monash Medical Centre, Level 3 P Block, 246 Clayton Road, Clayton, Victoria, 3168, Australia

e Box Hill Hospital, Department Psychiatry, 131 Thames St, Box Hill, Victoria, 3128, Australia

Corresponding author. Mental Health Research Institute, Locked bag 11, Parkville, Victoria, 3052, Australia. Tel.: +61 3 9895 4965; fax: +61 3 9895 4993.

PII: S0920-9964(05)00091-5

doi:10.1016/j.schres.2005.03.005

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