Publication

Assessment of mental capacity to consent to treatment in anorexia nervosa: A comparison of clinical judgment and MacCAT-T and consequences for clinical practice

Elzakkers, I. F. F. M., Danner, U. N., Grisso, T., Hoek, H. W. & van Elburg, A. A., May-2018, In : International Journal of Law and Psychiatry. 58, p. 27-35 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Elzakkers, I. F. F. M., Danner, U. N., Grisso, T., Hoek, H. W., & van Elburg, A. A. (2018). Assessment of mental capacity to consent to treatment in anorexia nervosa: A comparison of clinical judgment and MacCAT-T and consequences for clinical practice. International Journal of Law and Psychiatry, 58, 27-35. https://doi.org/10.1016/j.ijlp.2018.02.001

Author

Elzakkers, Isis F. F. M. ; Danner, Unna N. ; Grisso, Thomas ; Hoek, Hans W. ; van Elburg, Annemarie A. / Assessment of mental capacity to consent to treatment in anorexia nervosa : A comparison of clinical judgment and MacCAT-T and consequences for clinical practice. In: International Journal of Law and Psychiatry. 2018 ; Vol. 58. pp. 27-35.

Harvard

Elzakkers, IFFM, Danner, UN, Grisso, T, Hoek, HW & van Elburg, AA 2018, 'Assessment of mental capacity to consent to treatment in anorexia nervosa: A comparison of clinical judgment and MacCAT-T and consequences for clinical practice' International Journal of Law and Psychiatry, vol. 58, pp. 27-35. https://doi.org/10.1016/j.ijlp.2018.02.001

Standard

Assessment of mental capacity to consent to treatment in anorexia nervosa : A comparison of clinical judgment and MacCAT-T and consequences for clinical practice. / Elzakkers, Isis F. F. M.; Danner, Unna N.; Grisso, Thomas; Hoek, Hans W.; van Elburg, Annemarie A.

In: International Journal of Law and Psychiatry, Vol. 58, 05.2018, p. 27-35.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Elzakkers IFFM, Danner UN, Grisso T, Hoek HW, van Elburg AA. Assessment of mental capacity to consent to treatment in anorexia nervosa: A comparison of clinical judgment and MacCAT-T and consequences for clinical practice. International Journal of Law and Psychiatry. 2018 May;58:27-35. https://doi.org/10.1016/j.ijlp.2018.02.001


BibTeX

@article{259cefe2f0354385b7b657af8cedfe54,
title = "Assessment of mental capacity to consent to treatment in anorexia nervosa: A comparison of clinical judgment and MacCAT-T and consequences for clinical practice",
abstract = "Informed consent requires adequate mental capacity to consent to treatment Mental capacity (MC) to consent to treatment refers to the ability to make medical decisions. MC is assessed in a general psychiatric interview, but this clinical assessment is known to overestimate mental capacity in patients and the inter rater reliability is low. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) has emerged as the gold standard to assess mental capacity to consent to treatment The MacCAT-T is a semi-structured interview designed to aid clinicians in this assessment and has shown good inter rater reliability in patients with schizophrenia and other mental disorders, but has hardly been studied in patients with anorexia nervosa. Patients with anorexia nervosa (AN) regularly avoid treatment, even when severely ill and discussion includes assessing MC to consent to treatment.The aim of this study is to compare clinical judgment and the MacCAT-T in evaluating MC in patients with AN which in turn may influence use of the MacCAT-T in daily practice.In a sample of 70 consecutively referred severely ill patients with AN with a mean BMI of 15.5 kg/m(2) and a mean duration of illness of 8.6 years, clinical assessment of MC by experienced psychiatrists and the outcome of the MacCAT-T interview were compared. Agreement (kappa-value) was calculated. Agreement between clinical assessment and outcome of the MacCAT-T was questionable (kappa 023). Unlike in other psychiatric populations, clinicians judged a high proportion of patients with AN as having diminished MC. The MacCAT-T can be useful in assessing MC in AN when used in addition to clinical judgment to aid clinicians in complex cases. Why clinicians judge a relatively high proportion of patients with AN as having diminished MC, in contrast to lower proportions in other psychiatric disorders, is an area in need of further research.",
keywords = "Mental capacity, Anorexia nervosa, MacCAT-T, MACARTHUR TREATMENT COMPETENCE, EATING-DISORDERS, DECISION-MAKING, MEDICAL INPATIENTS, CENTRAL COHERENCE, EPIDEMIOLOGY, PREVALENCE, MORTALITY, EMOTION, RISK",
author = "Elzakkers, {Isis F. F. M.} and Danner, {Unna N.} and Thomas Grisso and Hoek, {Hans W.} and {van Elburg}, {Annemarie A.}",
year = "2018",
month = "5",
doi = "10.1016/j.ijlp.2018.02.001",
language = "English",
volume = "58",
pages = "27--35",
journal = "International Journal of Law and Psychiatry",
issn = "0160-2527",
publisher = "PERGAMON-ELSEVIER SCIENCE LTD",

}

RIS

TY - JOUR

T1 - Assessment of mental capacity to consent to treatment in anorexia nervosa

T2 - A comparison of clinical judgment and MacCAT-T and consequences for clinical practice

AU - Elzakkers, Isis F. F. M.

AU - Danner, Unna N.

AU - Grisso, Thomas

AU - Hoek, Hans W.

AU - van Elburg, Annemarie A.

PY - 2018/5

Y1 - 2018/5

N2 - Informed consent requires adequate mental capacity to consent to treatment Mental capacity (MC) to consent to treatment refers to the ability to make medical decisions. MC is assessed in a general psychiatric interview, but this clinical assessment is known to overestimate mental capacity in patients and the inter rater reliability is low. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) has emerged as the gold standard to assess mental capacity to consent to treatment The MacCAT-T is a semi-structured interview designed to aid clinicians in this assessment and has shown good inter rater reliability in patients with schizophrenia and other mental disorders, but has hardly been studied in patients with anorexia nervosa. Patients with anorexia nervosa (AN) regularly avoid treatment, even when severely ill and discussion includes assessing MC to consent to treatment.The aim of this study is to compare clinical judgment and the MacCAT-T in evaluating MC in patients with AN which in turn may influence use of the MacCAT-T in daily practice.In a sample of 70 consecutively referred severely ill patients with AN with a mean BMI of 15.5 kg/m(2) and a mean duration of illness of 8.6 years, clinical assessment of MC by experienced psychiatrists and the outcome of the MacCAT-T interview were compared. Agreement (kappa-value) was calculated. Agreement between clinical assessment and outcome of the MacCAT-T was questionable (kappa 023). Unlike in other psychiatric populations, clinicians judged a high proportion of patients with AN as having diminished MC. The MacCAT-T can be useful in assessing MC in AN when used in addition to clinical judgment to aid clinicians in complex cases. Why clinicians judge a relatively high proportion of patients with AN as having diminished MC, in contrast to lower proportions in other psychiatric disorders, is an area in need of further research.

AB - Informed consent requires adequate mental capacity to consent to treatment Mental capacity (MC) to consent to treatment refers to the ability to make medical decisions. MC is assessed in a general psychiatric interview, but this clinical assessment is known to overestimate mental capacity in patients and the inter rater reliability is low. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) has emerged as the gold standard to assess mental capacity to consent to treatment The MacCAT-T is a semi-structured interview designed to aid clinicians in this assessment and has shown good inter rater reliability in patients with schizophrenia and other mental disorders, but has hardly been studied in patients with anorexia nervosa. Patients with anorexia nervosa (AN) regularly avoid treatment, even when severely ill and discussion includes assessing MC to consent to treatment.The aim of this study is to compare clinical judgment and the MacCAT-T in evaluating MC in patients with AN which in turn may influence use of the MacCAT-T in daily practice.In a sample of 70 consecutively referred severely ill patients with AN with a mean BMI of 15.5 kg/m(2) and a mean duration of illness of 8.6 years, clinical assessment of MC by experienced psychiatrists and the outcome of the MacCAT-T interview were compared. Agreement (kappa-value) was calculated. Agreement between clinical assessment and outcome of the MacCAT-T was questionable (kappa 023). Unlike in other psychiatric populations, clinicians judged a high proportion of patients with AN as having diminished MC. The MacCAT-T can be useful in assessing MC in AN when used in addition to clinical judgment to aid clinicians in complex cases. Why clinicians judge a relatively high proportion of patients with AN as having diminished MC, in contrast to lower proportions in other psychiatric disorders, is an area in need of further research.

KW - Mental capacity

KW - Anorexia nervosa

KW - MacCAT-T

KW - MACARTHUR TREATMENT COMPETENCE

KW - EATING-DISORDERS

KW - DECISION-MAKING

KW - MEDICAL INPATIENTS

KW - CENTRAL COHERENCE

KW - EPIDEMIOLOGY

KW - PREVALENCE

KW - MORTALITY

KW - EMOTION

KW - RISK

U2 - 10.1016/j.ijlp.2018.02.001

DO - 10.1016/j.ijlp.2018.02.001

M3 - Article

VL - 58

SP - 27

EP - 35

JO - International Journal of Law and Psychiatry

JF - International Journal of Law and Psychiatry

SN - 0160-2527

ER -

ID: 74546960