Limits on the use of the MMSE for assessment of capacity to consent for treatment
- I. Álvarez Marrodán
- B.S. Baón Pérez
- M. Navío Acosta
- E.J. Verdura Vizcaino
- M.B. Cantón Álvarez
- T. Ventura Faci
ISSN: 0213-6163
Año de publicación: 2018
Volumen: 32
Número: 3
Páginas: 153-157
Tipo: Artículo
Otras publicaciones en: European journal of psychiatry
Resumen
This study explores to what extent patients scoring in the normal Mini-Mental Status Examination (MMSE) cognitive range have mental incapacity to consent to treatment; and analyzes the relationship between MMSE score and MacArthur Competence Assessment Tool for Treatment (MacCAT-T) scores. Eighty medical inpatients, 40 psychiatric inpatients and 40 healthy controls were assessed. The criterion of expert psychiatrists was the ‘gold standard’ for capacity. Seven (63.6%) psychiatric patients and two (14.3%) medical patients without capacity performed in a normal MMSE cognitive range (p < 0.001). Statistically significant correlations between MMSE scores and mean MacCAT-T scores were observed in both patient groups (particularly in ‘understanding’ and ‘reasoning’). The MMSE should not be used on its own for assessment of capacity.
Información de financiación
Referencias bibliográficas
- T. Ventura, M. Navío, I. Alvarez, B. Baon. La evaluación de la capacidad y sus problemas. Revista Eidon, 41 (2014), pp. 12-27
- P.S. Appelbaum. Clinical practice, assessment of patients’ competence to consent to treatment. N Engl J Med, 357 (2007), pp. 1834-1840
- V. Raymont, W. Bingley, A. Buchanan, A.S. David, P. Hayward, S. Wessely, et al. Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study. Lancet, 364 (2004), pp. 1421-1427
- I. Alvarez Marrodán, B. Baón Pérez, M. Navío Acosta, R. López-Antón, E. Lobo Escolar, T. Ventura Faci. Spanish validation of the MacArthur Competence Assessment Tool for Treatment interview to assess patients competence to consent treatment. Med Clin (Barc), 143 (2014), pp. 201-204
- L.B. Dunn, M.A. Nowrangi, B.W. Palmer, D.V. Jeste, E.R. Saks. Assessing decisional capacity for clinical research or treatment: a review of instruments. Am J Psychiatry, 163 (2006), pp. 1323-1334
- D. Okai, G. Owen, H. McGuire, S. Singh, R. Churchill, M. Hotopf. Mental capacity in psychiatric patients: systematic review. Br J Psychiatry, 191 (2007), pp. 291-297
- A. Lobo, P. Saz, G. Marcos, J.L. Día, C. de la Cámara, T. Ventura, et al. Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population. Med Clin (Barc), 112 (1999), pp. 767-774
- T. Grisso, P.S. Appelbaum. Assessing competence to consent to treatment. A guide for physicians and other health professionals. Oxford University Press, Nueva York (1998)
- N. Bilanakis, A. Vratsista, E. Athanasiou, D. Niakas, V. Peritogiannis. Medical patients’ treatment decision making capacity: a report from a general hospital in Greece. Clin Pract Epidemiol Ment Health, 10 (2014), pp. 133-139
- G. Mandarelli, F. Carabellese, G. Parmigiani, F. Bernardini, L. Pauselli, R. Quartesan, et al. Treatment decision-making capacity in non-consensual psychiatric treatment: a multicentre study. Epidemiol Psychiatr Sci, 9 (2017), pp. 1-8