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    Competence of depressed patients for consent to research

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    Authors
    Appelbaum, Paul S.
    Grisso, Thomas
    Frank, Ellen
    O'Donnell, Sandra M.
    Kupfer, David J.
    UMass Chan Affiliations
    Department of Psychiatry
    Document Type
    Journal Article
    Publication Date
    1999-09-15
    Keywords
    Adult
    Ambulatory Care
    Behavioral Research
    Comprehension
    Decision Making
    Depressive Disorder
    Female
    Humans
    *Informed Consent
    *Mental Competency
    *Mentally Ill Persons
    Middle Aged
    *Patient Selection
    Psychiatric Status Rating Scales
    Psychotherapy
    Severity of Illness Index
    Life Sciences
    Medicine and Health Sciences
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    Link to Full Text
    https://doi.org/10.1176/ajp.156.9.1380
    Abstract
    OBJECTIVE: The capacities of depressed patients to consent to research have been questioned by commentators who fear that the cognitive effects of a disorder may impair subjects' abilities to protect their interests. This study used a new instrument for assessing depressed patients' capacities to consent to research and examined their performance, including the relation between severity of depression and extent of impairment. METHOD: Twenty-six female outpatients with major depression (assessed with the Schedule of Affective Disorders and Schizophrenia-Lifetime Version) enrolled in a study of maintenance psychotherapy were recruited for this project. Consent-related abilities were measured with the MacArthur Competence Assessment Tool-Clinical Research (MacCAT-CR) 1 week after intake and again 8-10 weeks later. Depressive symptoms were measured by the Hamilton Depression Rating Scale. RESULTS: Almost all subjects performed quite well on the capacity measures and maintained that level of performance over time. There was no correlation between performance and degree of depressive symptoms and little relation to prior research experience. Some subjects appeared confused about the extent to which decisions about assignment to treatment groups would be made on the basis of their clinical condition rather than randomly. CONCLUSIONS: This outpatient group with major depression showed few impairments in their decision-making capacities related to research. As in other studies, some concerns were raised about subjects' appreciation that treatment assignments would not be individualized for their needs. Examination of hospitalized patients and those with psychotic depression would help to determine whether they show greater degrees of impairment. The MacCAT-CR was easily adapted for use with this depressed group.
    Source

    Am J Psychiatry. 1999 Sep;156(9):1380-4.

    DOI
    10.1176/ajp.156.9.1380
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/38506
    PubMed ID
    10484948
    Related Resources

    Link to article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1176/ajp.156.9.1380
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