Do psychiatric patients improve their competency to consent to hospitalization after admission? A prospective study in an acute inpatient ward.
OBJECTIVE
Competency to consent to hospitalization has important clinical and ethical implications. However, there are no follow-up studies that evaluate improvement in competency during psychiatric hospitalization. The authors sought to determine whether patients admitted to a psychiatric ward as incompetent to consent to hospitalization improve their competency during hospitalization.


METHODS
A total of 160 consecutively admitted patients were administered the Competency Questionnaire (CQ), a structured scale designed to assess competency to consent to psychiatric hospitalization. The CQ was administered both upon admission and at discharge. Severity and acuity of the psychiatric disorder were assessed with the Severity of Psychiatric Illness Scale and the Acuity of Psychiatric Illness Scale.


RESULTS
Of the 160 assessed patients, 70 (43.8%) were rated incompetent. Forty-five of these 70 incompetent patients completed the admission-to-discharge follow-up. Twenty-one of these 45 patients (46.6%) remained incompetent at discharge. Participation in the treatment process was the only variable that predicted improvement on competency during hospitalization. Severity of psychiatric illness at admission did not predict improvement on competency.


CONCLUSIONS
Nearly half of the patients who upon admission were incompetent remained incompetent at discharge.
Fraguas
David
D
Department of Psychiatry, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain. dfraguash@yahoo.es
García-Solano
Fernando
F
Chapela
Esther
E
Terán
Sara
S
de la Peña
Juan José
JJ
Calcedo-Barba
Alfredo
A
D000208:Acute Disease; D000328:Adult; D003072:Cognition Disorders / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007258:Informed Consent; D008297:Male; D016743:Mental Competency; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires