title: Psychopathology, psychopharmacological properties, decision-making capacity to consent to clinical research and the willingness to participate among long-term hospitalized patients with schizophrenia.
abstract: Many studies discuss factors related to the decision-making capacity to consent to clinical research (DMC) of patients with schizophrenia. However, these studies rarely approached willingness to participate and the association between psychopharmacological properties (e.g., antipsychotic-induced side effects) and DMC. This study aimed to explore factors related to DMC and willingness to participate in patients with schizophrenia. All 139 patients with schizophrenia were assessed with the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) and other measures. A linear regression model was used to find the predictors of MacCAT-CR scores. A logistic regression model was used for exploring the predictors of willingness to participate. Patients with more severe negative symptoms performed poorly in DMC outcomes. In addition, females, those with fewer years of education and reduced cognitive function are more likely to experience difficulties in decision-making. Forty-three subjects (30.4%) chose to participate. Patients with higher level of positive symptoms, longer length of stay, higher burden of anticholinergics and users of atypical antipsychotics were more likely to participate in a clinical study which aimed to "enhance cognition". These finding suggest that research investigators should consider many variables for patients who require more intensive screening for impaired DMC.
authors: Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Bo-Jian
authors: BJ
authors: Wu
authors: Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan.
authors: Hsun-Yi
authors: HY
authors: Liao
authors: Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan.
authors: Hsing-Kang
authors: HK
authors: Chen
authors: Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Neuropsychiatric Research, NHRI, Miaoli, Taiwan. Electronic address: tosafish@gmail.com.
authors: Tsuo-Hung
authors: TH
authors: Lan
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000494:pharmacology; D035843:Biomedical Research; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D003657:Decision Making / Q000502:physiology*; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology*; D012737:Sex Factors; D013624:Taiwan
chemical_list: D014150:Antipsychotic Agents
keywords: Decision-making capacity; MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR); Negative symptoms; Psychopathology; Psychopharmacology; Schizophrenia; Taiwan