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

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    Authors
    Kennedy, Miriam
    Dornan, Julieanne
    Rutledge, Emer
    O'Neill, Helen
    Kennedy, Harry G
    Affiliation
    Central Mental Hospital, Dublin, Ireland.
    Issue Date
    2011-04-27T14:06:05Z
    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
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    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
    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
    ISSN
    1873-6386
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijlp.2009.09.006
    Scopus Count
    Collections
    St. Patrick's University Hospital

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