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Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial.

Publication ,  Journal Article
Stroup, S; Appelbaum, P; Swartz, M; Patel, M; Davis, S; Jeste, D; Kim, S; Keefe, R; Manschreck, T; McEvoy, J; Lieberman, J
Published in: Schizophr Res
December 1, 2005

OBJECTIVE: Uncertainty regarding the degree to which persons with schizophrenia may lack decision-making capacity, and what the predictors of capacity may be led us to examine the relationship between psychopathology, neurocognitive functioning, and decision-making capacity in a large sample of persons with schizophrenia at entry into a clinical trial. METHOD: In the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial, a clinical trial sponsored by the National Institute of Mental Health designed to compare the effectiveness of antipsychotic drugs, subjects were administered the MacArthur Competence Assessment Tool-Clinical Research (MacCAT-CR) and had to demonstrate adequate decision-making capacity before randomization. The MacCAT-CR, the Positive and Negative Syndrome Scale (PANSS), and an extensive neurocognitive battery were completed for 1447 study participants. RESULTS: The neurocognitive composite score and all 5 neurocognitive subscores (verbal memory, vigilance, processing speed, reasoning, and working memory) were positive correlates of the MacCAT-CR understanding, appreciation, and reasoning scales at baseline. Higher levels of negative symptoms, but not positive symptoms, were inversely correlated with these three MacCAT-CR scales. Linear regression models of all three MacCAT-CR scales identified working memory as a predictor; negative symptoms made a small contribution to the understanding and appreciation scores. CONCLUSIONS: Negative symptoms and aspects of neurocognitive functioning were correlated with decision-making capacity in this large sample of moderately ill subjects with schizophrenia. In multiple regression models predicting performance on the MacCAT-CR scales, working memory was the only consistent predictor of the components of decision-making capacity. Individuals with schizophrenia who have prominent cognitive dysfunction, especially memory impairment, may warrant particular attention when participating in research.

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Published In

Schizophr Res

DOI

ISSN

0920-9964

Publication Date

December 1, 2005

Volume

80

Issue

1

Start / End Page

1 / 8

Location

Netherlands

Related Subject Headings

  • Severity of Illness Index
  • Schizophrenia
  • Psychiatry
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Humans
  • Female
  • Decision Making
  • Cross-Sectional Studies
 

Citation

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Stroup, S., Appelbaum, P., Swartz, M., Patel, M., Davis, S., Jeste, D., … Lieberman, J. (2005). Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial. Schizophr Res, 80(1), 1–8. https://doi.org/10.1016/j.schres.2005.08.007
Stroup, Scott, Paul Appelbaum, Marvin Swartz, Mukesh Patel, Sonia Davis, Dilip Jeste, Scott Kim, et al. “Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial.Schizophr Res 80, no. 1 (December 1, 2005): 1–8. https://doi.org/10.1016/j.schres.2005.08.007.
Stroup S, Appelbaum P, Swartz M, Patel M, Davis S, Jeste D, et al. Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial. Schizophr Res. 2005 Dec 1;80(1):1–8.
Stroup, Scott, et al. “Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial.Schizophr Res, vol. 80, no. 1, Dec. 2005, pp. 1–8. Pubmed, doi:10.1016/j.schres.2005.08.007.
Stroup S, Appelbaum P, Swartz M, Patel M, Davis S, Jeste D, Kim S, Keefe R, Manschreck T, McEvoy J, Lieberman J. Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial. Schizophr Res. 2005 Dec 1;80(1):1–8.
Journal cover image

Published In

Schizophr Res

DOI

ISSN

0920-9964

Publication Date

December 1, 2005

Volume

80

Issue

1

Start / End Page

1 / 8

Location

Netherlands

Related Subject Headings

  • Severity of Illness Index
  • Schizophrenia
  • Psychiatry
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Humans
  • Female
  • Decision Making
  • Cross-Sectional Studies