P02-71 - Competence to give informed consent in acute psychiatric hospitalization. Preliminary results from a case-control study

Objectives: To asses competence to consent to treatment in involuntary committed patients (ICP) for a mental disorder, as compared to matched acute voluntary hospitalized patients (VHP). To evaluate the effect of psychopathology severity and cognitive dysfunction on decisional capacity. Methods: Cases were recruited among ICP at the Umberto I Hospital, ‘Sapienza’ University of Rome; controls were age- and sex-matched VHP, in the same ward and time period. Subjects were diagnosed according to DSM-IV-TR criteria and further evaluated through a) MacArthur Competence Assessment Tool for Treatment (MacCAT-T) b) Brief Psychiatric Rating Scale-24 (BPRS) c) Raven''s Colored Progressive Matrices (CPM) d) Mini Mental State Examination (MMSE). Results: Eighteen cases were enrolled (67% women), mean age was 25.1±2.8 years. There were no differences between groups in: diagnostic distribution (40% schizophrenic spectrum disorders, 40% mood disorders, 20% other diagnosis), disease duration, MMSE. ICP had higher BPRS total scores (mean difference ± S.D.= 10.3±19.4; [95% C.I.= 0.6 ÷ -20.0]), and performed worse than VHP in MacCAT-T comprehension (-1.0±1.3; [95% C.I.= -1.6 ÷ -0.3]), appreciation (-1,7±2.0; [95% C.I.= -3.0 ÷ -0.7]), reasoning (-2.1±2.9; [95% C.I.= -3.6 ÷ -0.7]) and expression of a choice (-0.8±1.0 [95% C.I.= -1.3 ÷ -0.3]). Competence to give informed consent was associated with psychopathological dimensions but not with MMSE and CPM scores, in the sample overall. Conclusion: Competence to consent to treatment was reduced in ICP compared to VHP. Involuntary commitment was not necessarily associated with incapability of making treatment decisions. [Copyright &y& Elsevier]