The aims of the present study are (1) to examine the degree to which severity of psychiatric symptoms and specific neuropsychological deficits among middle-aged and elderly schizophrenia patients are associated with specific aspects of their capacity to make informed decisions about their own treatment, and (2) to examine the modifiability and stability of patients' capacity to understand treatment disclosures. Subjects will be 64 DSM-IV/SCID diagnosed schizophrenia patients age 40 or older who, for clinically initiated reasons, are being asked by their respective psychiatrists to consider treatment with an atypical anti-psychotic medication. All subjects will be assessed with measures of treatment- related decision making capacity, severity of psychiatric symptoms, and a comprehensive neuropsychological battery. Also, one of the measures involving understanding of information in an understanding with repeated exposures. Psychiatric symptoms and decision making capacity will be reassessed at a 1-month follow-up visit. It is hypothesized that severity of psychiatric symptoms and specific neuropsychological deficits will be differentially associated with specific aspects of decision making capacity, and that repeated learning trials will yield improved understanding in patients who had initial difficulty understanding information in a treatment disclosure. It is also hypothesized that improvements in understanding of disclosed information achieved through multiple learning trials will be at least partially maintained over a 1-month follow-up period. We will envision the proposed study as the first step in a longer term research program to develop more effective methods of providing treatment disclosures as well as patient-focused interventions to maximize each patient's capacity to make informed decisions about his or her treatment.
| Palmer, Barton W; Nayak, Gauri V; Dunn, Laura B et al. (2002) Treatment-related decision-making capacity in middle-aged and older patients with psychosis: a preliminary study using the MacCAT-T and HCAT. Am J Geriatr Psychiatry 10:207-11 |
