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BJPsych Open. 2017 May 26;3(3):147-153. doi: 10.1192/bjpo.bp.116.003905. eCollection 2017 May.

Mental capacity to consent to treatment and the association with outcome: a longitudinal study in patients with anorexia nervosa.

Author information

1
, MD, MSc, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands.
2
, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands; Department of Psychology, Utrecht University, Utrecht, The Netherlands.
3
, PhD, Department of Psychology, Utrecht University, Utrecht, The Netherlands.
4
, PhD, Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands.
5
, MD, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands; Parnassia Psychiatric Institute, The Hague, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Department of Epidemiology, Mailman School of Public Health, Columbia University New York, USA.
6
, MD, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands; Department of Psychology, Utrecht University, Utrecht, The Netherlands.

Abstract

BACKGROUND:

Relevance of diminished mental capacity in anorexia nervosa (AN) to course of disorder is unknown.

AIMS:

To examine prognostic relevance of diminished mental capacity in AN.

METHOD:

A longitudinal study was conducted in 70 adult female patients with severe AN. At baseline, mental capacity was assessed by psychiatrists, and clinical and neuropsychological data (decision-making) were collected. After 1 and 2 years, clinical and neuropsychological assessments were repeated, and remission and admission rates were calculated.

RESULTS:

People with AN with diminished mental capacity had a less favourable outcome with regard to remission and were admitted more frequently. Their appreciation of illness remained hampered. Decision-making did not improve, in contrast to people with full mental capacity.

CONCLUSIONS:

People with AN with diminished mental capacity seem to do less well in treatment and display decision-making deficiencies that do not ameliorate with weight improvement.

DECLARATION OF INTEREST:

None.

COPYRIGHT AND USAGE:

© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

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