title: Preliminary Turkish study of psychiatric in-patients' competence to make treatment decisions.
abstract: BACKGROUND
  Competence is a prerequisite for informed consent. Patients who are found to be competent are entitled to accept or refuse the proposed treatment. In recent years, there has been an increased interest in studies examining competence for treatment in psychiatric patients. In this study, we aimed to investigate the decision-making competencies of inpatients with a range of psychiatric diseases.
  
  
  METHODS
  This study was carried out at the psychiatry clinic of Kocaeli University Hospital in Turkey from June 2007 to February 2008. Decision-making competence was assessed in 83 patients using the MacArthur Competence Assessment Tool-Treatment (MacCAT-T).
  
  
  RESULTS
  The study groups consisted of patients with mood (39.8%), psychotic (27.7%) and anxiety disorders (18.1%), and alcohol/substance addiction (14.5%). There was a significant relation between decision-making competence and demographic and clinical characteristics. Appreciation of the given information was more impaired in psychotic disorder patients than in other patients, but understanding and reasoning of the given information was similar in all groups.
  
  
  CONCLUSIONS
  These results reveal the importance of evaluating decision-making competencies of psychiatric patients before any treatment or intervention is carried out to ascertain their ability to give informed consent to treatment. Institutional and national policies need to be determined and put into practice relating to the assessment and management of competence in patients with psychiatric disorders.
authors.affiliation: Vocational School of Health, Kocaeli University, Kocaeli, Turkey. raay@kocaeli.edu.tr
authors.forename: Rahime
authors.initials: R
authors.lastname: Aydin Er
authors.forename: Mine
authors.initials: M
authors.lastname: Sehiralti
authors.forename: Ahmet Tamer
authors.initials: AT
authors.lastname: Aker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003657:Decision Making / Q000941:ethics*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000523:psychology*; D007297:Inpatients / Q000523:psychology; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D028701:Patient Rights / Q000941:ethics; D011050:Policy Making; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry / Q000941:ethics* / Q000331:legislation & jurisprudence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology; D014421:Turkey; D055815:Young Adult
keywords: clinical ethics; informed consent; mental competence; patient; psychiatry