Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Kovnick, J. A. Articles by Leadbetter, R. A. Search for Related Content PubMed Citation Articles by Kovnick, J. A. Articles by Leadbetter, R. A. Informed Consent Research Design, Methodology Schizophrenia Spectrum Disorders

Competence to Consent to Research Among Long-Stay Inpatients With Chronic Schizophrenia

OBJECTIVE: Questions have been posed about the competence of persons with serious mental illness to consent to participate in clinical research. This study compared competence-related abilities of hospitalized persons with schizophrenia with those of a comparison sample of persons from the community who had never had a psychiatric hospitalization. METHODS: The study participants were administered the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), a structured instrument designed to aid in the assessment of competence to consent to clinical research. The scores of 27 persons who met DSM-IV criteria for schizophrenia who were long-stay patients on a state hospital research ward were compared with those of 24 individuals from the community who were of similar age, gender, race, and socioeconomic status. RESULTS: Significant differences were found between the patients and the community sample on three measures of competence-related abilities: understanding, reasoning, and appreciation. Degree of psychopathology and cognitive functioning were significantly negatively correlated with understanding and appreciation among the patients with schizophrenia. Length of hospitalization was significantly negatively correlated with all measures of decision-making capacities. CONCLUSIONS: The generally poor performance of the long-stay patients with chronic schizophrenia highlights the difficulties this group is likely to encounter in providing consent to research. However, variation across the sample points to the need for individualized assessment and for validated techniques for facilitating decision making in the face of decisional impairments.

This article has been cited by other articles:

				S. Y. H. Kim, P. S. Appelbaum, J. Swan, T. S. Stroup, J. P. McEvoy, D. C. Goff, D. V. Jeste, J. S. Lamberti, A. Leibovici, and E. D. Caine Determining when impairment constitutes incapacity for informed consent in schizophrenia research The British Journal of Psychiatry, July 1, 2007; 191(1): 38 - 43. [Abstract] [Full Text] [PDF]

				P. P. Christopher, M. E. Foti, K. Roy-Bujnowski, and P. S. Appelbaum Consent Form Readability and Educational Levels of Potential Participants in Mental Health Research Psychiatr Serv, February 1, 2007; 58(2): 227 - 232. [Abstract] [Full Text] [PDF]

				L. B. Dunn, M. A. Nowrangi, B. W. Palmer, D. V. Jeste, and E. R. Saks Assessing Decisional Capacity for Clinical Research or Treatment: A Review of Instruments Am J Psychiatry, August 1, 2006; 163(8): 1323 - 1334. [Abstract] [Full Text] [PDF]

				P. F. Schulte Risk of Clozapine-Associated Agranulocytosis and Mandatory White Blood Cell Monitoring Ann. Pharmacother., April 1, 2006; 40(4): 683 - 688. [Abstract] [Full Text] [PDF]

				P. S Appelbaum Decisional Capacity of Patients With Schizophrenia to Consent to Research: Taking Stock Schizophr Bull, January 1, 2006; 32(1): 22 - 25. [Abstract] [Full Text] [PDF]

				B. W Palmer and D. V Jeste Relationship of Individual Cognitive Abilities to Specific Components of Decisional Capacity Among Middle-Aged and Older Patients With Schizophrenia Schizophr Bull, January 1, 2006; 32(1): 98 - 106. [Abstract] [Full Text] [PDF]

				L. B Dunn, P. J Candilis, and L. W. Roberts Emerging Empirical Evidence on the Ethics of Schizophrenia Research Schizophr Bull, January 1, 2006; 32(1): 47 - 68. [Abstract] [Full Text] [PDF]

				D. V Jeste, C. A Depp, and B. W Palmer Magnitude of Impairment in Decisional Capacity in People With Schizophrenia Compared to Normal Subjects: An Overview Schizophr Bull, January 1, 2006; 32(1): 121 - 128. [Abstract] [Full Text] [PDF]

				B. E. McDermott, J. B. Gerbasi, C. Quanbeck, and C. L. Scott Capacity of Forensic Patients to Consent to Research: The Use of the MacCAT-CR J Am Acad Psychiatry Law, September 1, 2005; 33(3): 299 - 307. [Abstract] [Full Text] [PDF]

				B. W. Palmer, L. B. Dunn, P. S. Appelbaum, S. Mudaliar, L. Thal, R. Henry, S. Golshan, and D. V. Jeste Assessment of Capacity to Consent to Research Among Older Persons With Schizophrenia, Alzheimer Disease, or Diabetes Mellitus: Comparison of a 3-Item Questionnaire With a Comprehensive Standardized Capacity Instrument Arch Gen Psychiatry, July 1, 2005; 62(7): 726 - 733. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2003 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us