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BJPsych Open. 2016 Mar 9;2(2):147-153. eCollection 2016 Mar.

Mental capacity to consent to treatment in anorexia nervosa: explorative study.

Author information

1
, MD, MSc.
2
, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands.
3
, MD, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands; Parnassia Bavo 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.
4
, MD, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands; Department of Social Sciences, Utrecht University, Utrecht, The Netherlands.

Abstract

BACKGROUND:

Mental capacity to consent to treatment in anorexia nervosa is a neglected area in clinical decision-making.

AIMS:

To examine clinical and neuropsychological parameters associated with diminished mental capacity in anorexia nervosa.

METHOD:

An explorative study was conducted in 70 adult female patients with severe anorexia nervosa. Mental capacity to consent to treatment was assessed by experienced psychiatrists. Further measurements included the MacCAT-T (to assess mental capacity status), a range of clinical measures (body mass index (BMI) and comorbidity) and neuropsychological tests assessing decision-making, central coherence and set-shifting capacity.

RESULTS:

Diminished mental capacity occurs in a third of patients with severe anorexia nervosa and is associated with a low BMI, less appreciation of illness and treatment, previous treatment for anorexia nervosa, low social functioning and poor set shifting.

CONCLUSIONS:

Assessment of diminished mental capacity in anorexia nervosa requires careful evaluation of not only BMI, but also the degree of appreciation of illness and treatment, history and the tendency to have a rigid thinking style.

DECLARATION OF INTEREST:

None.

COPYRIGHT AND USAGE:

© The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

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