Shi-Bin Wang1, Yuan-Yuan Wang1, Gabor S Ungvari2, Chee H Ng3, Ren-Rong Wu4, Jijun Wang5, Yu-Tao Xiang6. 1. Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China. 2. University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia. 3. Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. 4. Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China. 5. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. 6. Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China. Electronic address: xyutly@gmail.com.
Abstract
OBJECTIVE: This meta-analysis aimed to examine the decisional capacity measured by the MacArthur Competence Assessment Tools (MacCAT) in schizophrenia. METHOD: English (PubMed, PsycINFO, Embase, Cochrane Library databases and the Cochrane Controlled Trials Register) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from 1995 until August 1, 2016. Weighted and standardized mean differences were calculated. The random effects model was used in all cases. RESULTS: Altogether 10 studies were identified, with 7 studies using the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) and 3 studies using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). The meta-analysis showed that there was significant impairment in decision-making capacity in schizophrenia patients compared to the healthy control group in terms of Understanding (SMD=-0.81, 95% CI: -1.06 to -0.56, P<0.001), Reasoning (SMD=-0.57, 95% CI: -0.80 to -0.34, P<0.001), Appreciation (SMD=-0.87, 95% CI: -1.20 to -0.53, P<0.001), and Expression a choice (SMD=-0.24, 95% CI: -0.43 to -0.05, P=0.01). CONCLUSION: Compared to the control group, schizophrenia patients are more likely to have impaired decision-making capacity in clinical research and treatment as measured by the MacCAT instruments. Researchers and clinicians need to consider the impaired decisional capacity in schizophrenia patients providing informed consent.
OBJECTIVE: This meta-analysis aimed to examine the decisional capacity measured by the MacArthur Competence Assessment Tools (MacCAT) in schizophrenia. METHOD: English (PubMed, PsycINFO, Embase, Cochrane Library databases and the Cochrane Controlled Trials Register) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from 1995 until August 1, 2016. Weighted and standardized mean differences were calculated. The random effects model was used in all cases. RESULTS: Altogether 10 studies were identified, with 7 studies using the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) and 3 studies using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). The meta-analysis showed that there was significant impairment in decision-making capacity in schizophreniapatients compared to the healthy control group in terms of Understanding (SMD=-0.81, 95% CI: -1.06 to -0.56, P<0.001), Reasoning (SMD=-0.57, 95% CI: -0.80 to -0.34, P<0.001), Appreciation (SMD=-0.87, 95% CI: -1.20 to -0.53, P<0.001), and Expression a choice (SMD=-0.24, 95% CI: -0.43 to -0.05, P=0.01). CONCLUSION: Compared to the control group, schizophreniapatients are more likely to have impaired decision-making capacity in clinical research and treatment as measured by the MacCAT instruments. Researchers and clinicians need to consider the impaired decisional capacity in schizophreniapatients providing informed consent.
Authors: Megan M Campbell; Ezra Susser; Sumaya Mall; Sibonile G Mqulwana; Michael M Mndini; Odwa A Ntola; Mohamed Nagdee; Zukiswa Zingela; Stephanus Van Wyk; Dan J Stein Journal: PLoS One Date: 2017-11-29 Impact factor: 3.240
Authors: A Calcedo-Barba; A Fructuoso; J Martinez-Raga; S Paz; M Sánchez de Carmona; E Vicens Journal: BMC Psychiatry Date: 2020-06-30 Impact factor: 3.630
Authors: Megan M Campbell; Jantina de Vries; Sibonile G Mqulwana; Michael M Mndini; Odwa A Ntola; Deborah Jonker; Megan Malan; Adele Pretorius; Zukiswa Zingela; Stephanus Van Wyk; Dan J Stein; Ezra Susser Journal: BMC Med Ethics Date: 2018-07-11 Impact factor: 2.652