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Article
A direct comparison of research decision-making capacity: schizophrenia/schizoaffective, medically ill, and non-ill subjects
Open Access Articles
  • Philip J. Candilis, University of Massachusetts Medical School
  • Kenneth E. Fletcher, University of Massachusetts Medical School
  • Cynthia M. A. Geppert, University of New Mexico
  • Charles W. Lidz, University of Massachusetts Medical School
  • Paul S. Appelbaum, University of Massachusetts Medical School
UMMS Affiliation
Department of Psychiatry
Date
1-1-2008
Document Type
Article
Subjects
Adult; Cognition Disorders; Comprehension; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Informed Consent; Male; *Mental Competency; Mental Recall; Mental Status Schedule; Middle Aged; Neuropsychological Tests; *Patient Selection; Psychiatric Status Rating Scales; Psychometrics; Psychotic Disorders; Schizophrenia; *Schizophrenic Psychology
Abstract

To characterize predictors of impairment in research decision-making capacity, we undertook a direct comparison of schizophrenia/schizoaffective (n=52), medically ill (diabetic; n=51), and non-ill (n=57) subjects. Scores on the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) were correlated with demographic variables and scores on the Positive and Negative Syndrome Scale (PANSS), Mini-Mental State Examination (MMSE), and Short-Form-36 (SF-36). Across diagnoses, cognitive capacity, physical functioning, and a diagnosis of mental illness had the greatest impact on decision-making capacity, with level of education also having an impact. 69-89% of schizophrenia/schizoaffective subjects attained MacCAT-CR subscale scores achieved by almost all comparison (98-100%) and medically ill (94-100%) subjects. Positive, negative, and general psychotic symptoms correlated with poorer scores. Prior research experience, number of queries used during interview, and emotional functioning also predicted MacCAT-CR scores. These data suggest that investigators and IRBs should consider a number of variables, many of which reach across diagnoses, as they decide which populations and individual subjects may require more intensive screening for decisional impairment or educational interventions to improve their abilities to make capable decisions about research participation.

Rights and Permissions
Citation: Schizophr Res. 2008 Feb;99(1-3):350-8. Link to article on publisher's site
DOI of Published Version
10.1016/j.schres.2007.11.022
Related Resources
Link to Article in PubMed
PubMed ID
18164593
Citation Information
Philip J. Candilis, Kenneth E. Fletcher, Cynthia M. A. Geppert, Charles W. Lidz, et al.. "A direct comparison of research decision-making capacity: schizophrenia/schizoaffective, medically ill, and non-ill subjects" Vol. 99 Iss. 1-3 (2008) ISSN: 0920-9964 (Print)
Available at: http://works.bepress.com/philip_candilis/8/