The relationship between executive functions and capacity to consent to treatment in acute psychiatric hospitalization

Gabriele Mandarelli, Giovanna Parmigiani, Lorenzo Tarsitani, Paola Frati, Massimo Biondi, Stefano Fer Racuti

Research output: Contribution to journalArticlepeer-review

Abstract

Despite the acknowledged influence of cognition on patients' capacity to consent to treatment, the specific neuropsychological domains involved remain elusive, as does the role of executive functions. We investigated possible associations between executive functions and decisional capacity in a sample of acute psychiatric inpatients. Patients were recruited and evaluated through the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the 24-item Brief Psychiatric Rating Scale (BPRS), the Mini-Mental State Examination (MMSE), and the Wisconsin Card Sorting Test (WCST). Patients with poor executive functioning performed worse in MacCAT understanding, appreciation, and expression of a choice, compared with good performers. These findings point to the importance of cognition in decisional capacity processes. In addition, the strong association found between learning abilities and informed consent decision-making provide empirical evidence indicating possible cognitive enhancement strategies that may improve psychiatric patients' competency.

Original languageEnglish
Pages (from-to)63-70
Number of pages8
JournalJournal of Empirical Research on Human Research Ethics
Volume7
Issue number5
DOIs
Publication statusPublished - 2012

Keywords

  • Executive functions
  • Informed consent
  • Severe mental illness

ASJC Scopus subject areas

  • Education
  • Communication
  • Social Psychology
  • Law

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