Cairns Ruth, Maddock Clementine, Buchanan Alec, David Anthony S, Hayward Peter, Richardson Genevra, Szmukler George, Hotopf Matthew
Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK.
Br J Psychiatry. 2005 Oct;187:379-85. doi: 10.1192/bjp.187.4.379.
Little is known about the proportion of psychiatric in-patients who lack capacity to make treatment decisions, or the associations of lack of capacity.
To determine the prevalence of psychiatric in-patients who lack capacity to make decisions about current treatment and to identify demographic and clinical associations with lack of mental capacity.
Patients (n=112) were interviewed soon after admission to hospital and a binary judgement of capacity was made, guided by the MacArthur Competence Tool for Treatment. Demographic and clinical information was collected from an interview and case notes.
Of the 112 participants, 49 (43.8%) lacked treatment-related decisional capacity. Mania and psychosis, poor insight, delusions and Black and minority ethnic group were associated with mental incapacity. Of the 49 patients lacking capacity, 30 (61%) were detained under the Mental Health Act 1983. Of the 63 with capacity, 6 (9.5%) were detained.
Lack of treatment-related decisional capacity is a common but by no means inevitable correlate of admission to a psychiatric in-patient unit.
对于缺乏做出治疗决策能力的精神科住院患者的比例，以及缺乏能力的相关因素，人们了解甚少。
确定缺乏对当前治疗做出决策能力的精神科住院患者的患病率，并确定与缺乏精神能力相关的人口统计学和临床因素。
患者（n = 112）在入院后不久接受访谈，并根据麦克阿瑟治疗能力工具进行能力的二元判断。通过访谈和病例记录收集人口统计学和临床信息。
在112名参与者中，49名（43.8%）缺乏与治疗相关的决策能力。躁狂和精神病、洞察力差、妄想以及黑人和少数族裔与精神无行为能力有关。在49名缺乏能力的患者中，30名（61%）根据1983年《精神健康法》被拘留。在63名有能力的患者中，6名（9.5%）被拘留。
缺乏与治疗相关的决策能力是精神科住院病房收治患者的常见但绝非必然的相关因素。
