The capacity to consent to treatment is altered in suicidal patients.

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2023-09-09 DOI:10.1186/s12991-023-00459-w
Emilie Olié, Thomas Catanzaro, Manon Malestroit, Julio A Guija, Lucas Giner, Philippe Courtet
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Abstract

Background: Many patients with depression refuse treatment. Moreover, suicide attempters often display low perceived need of treatment and impaired decision-making. These observations raise questions about the capacity to treatment consent in depressed suicide attempters (SA).

Methods: In patients with current depressive episode (N = 33 SAs and N = 27 non-SAs), consent capacity was evaluated with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), insight with the Beck Cognitive Insight Scale, and depression severity with the Beck Depression Inventory (BDI).

Results: The median BDI score in the whole sample (N = 60) was 21 [10;36], and was higher in SAs than non-SAs (27 [11;36] vs. 15 [10:33], p < 0.001). Consent capacity was impaired in 30% (appreciation), 53% (reasoning) and 60% (understanding) of all patients. MacCAT-T sub-scores were lower in SAs than non-SAs (understanding: 4.4 [2.35;5.8] vs. 5.3 [3.13;6]); appreciation: 3 [1;4] vs. 4 [2;4]); reasoning (4 [1;7] vs. 7 [3;8]), and ability to express a choice: 1 [0;2] vs. 2 [0;2]; all p < 0.001). In multivariate analyses, suicide attempt history and depression severity (but not insight) were negatively associated with MacCAT-T sub-scores.

Conclusion: More research is needed on the capacity to consent to treatment of patients with depression, particularly suicidal individuals, to make informed choices about their treatment. Trial registration The Montpellier University Hospital Institutional Review Board approved the study (No. 202100714).

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有自杀倾向的病人同意治疗的能力发生了改变。
背景:许多抑郁症患者拒绝治疗。此外,自杀未遂者通常表现出较低的治疗需求和受损的决策。这些观察结果提出了对抑郁症自杀未遂者的同意治疗能力的问题。方法:在当前抑郁发作的患者中(N = 33例SAs和N = 27例非SAs),使用麦克阿瑟治疗能力评估工具(MacCAT-T)评估同意能力,使用贝克认知洞察力量表评估洞察力,使用贝克抑郁量表(BDI)评估抑郁严重程度。结果:整个样本(N = 60)的中位BDI评分为21 [10;36],sa组高于非sa组(27 [11;36]vs. 15[10:33]。p结论:需要更多的研究来了解抑郁症患者,特别是自杀倾向者,同意治疗的能力,以做出明智的治疗选择。蒙彼利埃大学医院机构审查委员会批准了该研究(编号202100714)。
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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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