López-Jaramillo Carlos, Tobler Chantal Aristizábal, Gómez Constanza Ovalle, Triana Jaime Escobar
Mood Disorders Program, Hospital Universitario San Vicente Fundación, Medellín, Colombia; Research Group in Psychiatry (GIPSI), Department of Psychiatry, Universidad de Antioquia, Medellín, Colombia.
Hospital Central de la Policía Nacional, Universidad Nacional de Colombia, and Universidad El Rosario, Bogotá, Colombia.
Rev Colomb Psiquiatr. 2016 Jul-Sep;45(3):194-200. doi: 10.1016/j.rcp.2016.01.002. Epub 2016 Mar 4.
Schizophrenia and bipolar disorder type I (BD-I) can affect patient autonomy and capacity to consent to participate in research. Other variables associated with the autonomy of patients must be explored in order to improve the quality of the currently available tools.
To evaluate the relationship between insight and the capacity to consent to participate in research in patients with BD-I and schizophrenia.
A cross-sectional and longitudinal study was conducted with 120 subjects (40 subjects with schizophrenia, 40 with BD-I, and 40 healthy controls). The tools used were the Scale Assessment Insight-Expanded (SAI-E) and the MacArthur Competence Assessment Tool-Treatment (MacCAT-CR), which was first adapted culturally, and its validity and reliability assessed. The results obtained on each scale were compared and the association between them were evaluated.
There is a direct correlation between the capacity to consent to research, measured using the MacCAT-CR tool, and the degree of insight, measured using the SAI-E scale, with an effect size of 1.3 for BD-I and 2.03 for schizophrenia.
The results suggest that there is a correlation between the degree of insight and the capacity to consent to research in subjects with schizophrenia and BD-I. Insight should therefore be included as a relevant variable to assess the capacity to consent, and future studies should include it when researching on or designing new tools which aim at a greater respect of patient autonomy.
精神分裂症和I型双相情感障碍（BD-I）会影响患者的自主性以及参与研究的同意能力。必须探究与患者自主性相关的其他变量，以提高现有工具的质量。
评估自知力与BD-I和精神分裂症患者参与研究的同意能力之间的关系。
对120名受试者（40名精神分裂症患者、40名BD-I患者和40名健康对照）进行了横断面和纵向研究。所使用的工具是扩展版自知力评估量表（SAI-E）和麦克阿瑟治疗能力评估工具（MacCAT-CR），首先对其进行了文化适应性调整，并评估了其效度和信度。比较了在每个量表上获得的结果，并评估了它们之间的关联。
使用MacCAT-CR工具测量的参与研究的同意能力与使用SAI-E量表测量的自知力程度之间存在直接相关性，BD-I的效应量为1.3，精神分裂症的效应量为2.03。
结果表明，精神分裂症和BD-I患者的自知力程度与参与研究的同意能力之间存在相关性。因此，自知力应作为评估同意能力的一个相关变量纳入考量，并且未来的研究在研究或设计旨在更尊重患者自主性的新工具时应将其纳入。
