Treatment-related decision-making capacity in middle-aged and older patients with psychosis: a preliminary study using the MacCAT-T and HCAT.

Full Abstract

The authors conducted a preliminary examination of treatment-related decision-making capacity (DMC) in middle-aged and older psychosis patients. The MacArthur Competency Assessment Tool for Treatment (MacCAT-T) was administered to measure DMC among 16 patients with psychotic disorders and without dementia (mean age:
54.6 [SD 7.2] years). The impact of repeated learning trials on patients' understanding was assessed with the Hopkins Competency Assessment Test (HCAT). Subjects were also assessed with the Positive And Negative Syndrome Scale and Mattis' Dementia Rating Scale. There was a wide range of performance on the MacCAT-T; the levels and range of MacCAT-T scores were similar to those previously reported among younger acutely hospitalized patients in the MacCAT-T validation study. Patients' understanding of disclosed material on the HCAT improved significantly over repeated presentations. Although there were no statistically significant correlations observed between DMC and demographic characteristics, severity of symptoms, or global cognitive deficits, the sample size provided limited power to detect such associations. Results point to the importance of assessing DMC and to the potential modifiability of initial difficulties in understanding.

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Author information

Author/s: Palmer, Barton W (BW); Nayak, Gauri V (GV); Dunn, Laura B (LB); Appelbaum, Paul S (PS); Jeste, Dilip V (DV);

Affiliation: Department of Psychiatry, University of California, San Diego, USA. bpalmer(-atsign-)ucsd.edu

Grants: MH01452 (Agency:NIMH NIH HHS) ; R03 MH62341 (Agency:NIMH NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.

Journal: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry (Am J Geriatr Psychiatry), published in United States. (Language: eng)

Reference: -2002 Mar-Apr; vol 10 (issue 2) : pp 207-11

Dates: Created 2002/04/01; Completed 2002/05/23; Revised 2007/11/14;

PMID: 11925282, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Decision Making
Female
Humans

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