Extra information about treatment is too much for the patient with psychosis.

Hdl Handle:
http://hdl.handle.net/10147/128774
Title:
Extra information about treatment is too much for the patient with psychosis.
Authors:
Kennedy, Miriam; Dornan, Julieanne; Rutledge, Emer; O'Neill, Helen; Kennedy, Harry G
Affiliation:
Central Mental Hospital, Dublin, Ireland.
Citation:
Extra information about treatment is too much for the patient with psychosis., 32 (6):369-76 Int J Law Psychiatry
Journal:
International journal of law and psychiatry
Issue Date:
27-Apr-2011
URI:
http://hdl.handle.net/10147/128774
DOI:
10.1016/j.ijlp.2009.09.006
PubMed ID:
19793614
Additional Links:
doi:10.1016/j.ijlp.2009.09.006
Abstract:
Case law across jurisdictions requires ever more complete disclosure of material facts when obtaining consent to treatment.; To determine whether giving extra information impairs the mental capacity to make decisions about treatment.; The MacCAT-T, MacCAT-FP, PANSS and GAF were administered to 88 detained forensic patients with psychosis. Two positive and two negative facts were given about each of two anti-psychotic drugs, and no treatment (twelve items). A choice was elicited. The criterion for incompetence was inability to express a choice. Two extra positive and two extra negative facts about each of the three options were given (twelve extra items) and a choice was again elicited, while repeating the MacCAT-T.; Giving extra information led to a decline in the total score on the MacCAT-T. Twenty one were initially unable to make a choice (24%). After additional information, 33 were incapable (37.5%, Chi-squared p<0.001). Those initially incapable had the lowest scores on all measures of functional capacity and GAF, with highest scores for symptoms. Those able to choose a treatment option had the highest levels of function and least symptoms. Those who became incapable had intermediate scores.; Giving extra information made an extra 15% unable to choose. Clinical judgement must be exercised concerning the amount of information disclosed. Deciding what is material to the individual is arbitrary when so few items of information can be processed. Greater use of guardianship and independent second opinions is recommended.
Item Type:
Article
Language:
en
MeSH:
Adult; Choice Behavior; Commitment of Mentally Ill; Comprehension; Decision Making; Disclosure; Female; Humans; Informed Consent; Ireland; Male; Mental Competency; Patient Education as Topic; Patient Participation; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Treatment Outcome
ISSN:
1873-6386

Full metadata record

DC FieldValue Language
dc.contributor.authorKennedy, Miriamen
dc.contributor.authorDornan, Julieanneen
dc.contributor.authorRutledge, Emeren
dc.contributor.authorO'Neill, Helenen
dc.contributor.authorKennedy, Harry Gen
dc.date.accessioned2011-04-27T14:06:05Z-
dc.date.available2011-04-27T14:06:05Z-
dc.date.issued2011-04-27T14:06:05Z-
dc.identifier.citationExtra information about treatment is too much for the patient with psychosis., 32 (6):369-76 Int J Law Psychiatryen
dc.identifier.issn1873-6386-
dc.identifier.pmid19793614-
dc.identifier.doi10.1016/j.ijlp.2009.09.006-
dc.identifier.urihttp://hdl.handle.net/10147/128774-
dc.description.abstractCase law across jurisdictions requires ever more complete disclosure of material facts when obtaining consent to treatment.-
dc.description.abstractTo determine whether giving extra information impairs the mental capacity to make decisions about treatment.-
dc.description.abstractThe MacCAT-T, MacCAT-FP, PANSS and GAF were administered to 88 detained forensic patients with psychosis. Two positive and two negative facts were given about each of two anti-psychotic drugs, and no treatment (twelve items). A choice was elicited. The criterion for incompetence was inability to express a choice. Two extra positive and two extra negative facts about each of the three options were given (twelve extra items) and a choice was again elicited, while repeating the MacCAT-T.-
dc.description.abstractGiving extra information led to a decline in the total score on the MacCAT-T. Twenty one were initially unable to make a choice (24%). After additional information, 33 were incapable (37.5%, Chi-squared p<0.001). Those initially incapable had the lowest scores on all measures of functional capacity and GAF, with highest scores for symptoms. Those able to choose a treatment option had the highest levels of function and least symptoms. Those who became incapable had intermediate scores.-
dc.description.abstractGiving extra information made an extra 15% unable to choose. Clinical judgement must be exercised concerning the amount of information disclosed. Deciding what is material to the individual is arbitrary when so few items of information can be processed. Greater use of guardianship and independent second opinions is recommended.-
dc.language.isoenen
dc.relation.urldoi:10.1016/j.ijlp.2009.09.006en
dc.subject.meshAdult-
dc.subject.meshChoice Behavior-
dc.subject.meshCommitment of Mentally Ill-
dc.subject.meshComprehension-
dc.subject.meshDecision Making-
dc.subject.meshDisclosure-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInformed Consent-
dc.subject.meshIreland-
dc.subject.meshMale-
dc.subject.meshMental Competency-
dc.subject.meshPatient Education as Topic-
dc.subject.meshPatient Participation-
dc.subject.meshPsychiatric Status Rating Scales-
dc.subject.meshPsychotic Disorders-
dc.subject.meshSchizophrenia-
dc.subject.meshSchizophrenic Psychology-
dc.subject.meshTreatment Outcome-
dc.titleExtra information about treatment is too much for the patient with psychosis.en
dc.typeArticleen
dc.contributor.departmentCentral Mental Hospital, Dublin, Ireland.en
dc.identifier.journalInternational journal of law and psychiatryen
dc.description.provinceLeinster-

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