Abstract:
AIMS:The objectives of this article are to discuss ethical issues of informed consent in cognitively impaired patients and review considerations for capacity determination. We will also discuss how to evaluate capacity, determine competence, and obtain informed consent when a patient is deemed incompetent. This review emphasizes how to carry out informed consent procedures when capacity is questionable and discusses measures supported for use when determining cognitively impaired patients' ability to consent. METHODS:Information was gathered from medical and psychological codes of ethics, peer-reviewed journals, published guidelines from health-care organizations (e.g., American Medical Association), and scholarly books. Google Scholar and PsycINFO were searched for articles related to 'informed consent' and 'cognitive impairment' published in English between 1975 and 2014. Relevant sources referenced in retrieved publications were subsequently searched and reviewed. RESULTS:We selected 49 sources generated by our search. Sources were included in our review if they presented information related to at least one of our focus areas. These areas included: review of informed consent ethics and procedures, review of cognitive impairment evaluations, recommendations for measuring cognitive capacity, and alternative forms of informed consent. CONCLUSIONS:Patients' cognitive impairments can hinder the ability of patients to understand treatment options. Evaluating the capacity of patients with cognitive impairment to understand treatment options is vital for valid informed consent and should be guided by best practices. Thus, proper identification of patients with questionable capacity, capacity evaluation, and determination of competence, as well as reliance upon appropriate alternative consent procedures, are paramount.
journal_name
Psychiatry Clin Neuroscijournal_title
Psychiatry and clinical neurosciencesauthors
Fields LM,Calvert JDdoi
10.1111/pcn.12289subject
Has Abstractpub_date
2015-08-01 00:00:00pages
462-71issue
8eissn
1323-1316issn
1440-1819journal_volume
69pub_type
杂志文章,评审abstract::A 65-year-old woman with hypertension developed slowly progressive memory disturbance and disorientation. She was diagnosed as having Alzheimer-type dementia according to clinical criteria. Later her cognitive deterioration was noted to fluctuate in parallel to her blood pressure. Magnetic resonance angiography and si...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.1998.tb00979.x
更新日期:1998-02-01 00:00:00
abstract:AIM:Tissue pH and RNA integrity are crucial quality-control indicators of human post-mortem brain tissues in the identification of the pathogeneses of neuropsychiatric disorders, but pH has not been measured as often due to limitations in the amount of tissue available. This study was designed to develop and validate a...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12863
更新日期:2019-09-01 00:00:00
abstract:AIMS:Long-term use of methamphetamine could induce psychosis, but consequences with regards to intelligence have seldom been investigated. Long-term use of alcohol could also result in intellectual deterioration. METHODS:The IQ of 34 methamphetamine-induced psychosis (MIP) patients (age, 28.7 +/- 6.1 years) and 34 alc...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2009.02035.x
更新日期:2010-02-01 00:00:00
abstract::Interleukin-1 (IL1) is an inflammatory cytokine and exerts neurodegenerative effects in the brain. Several studies have indicated that IL1 is likely to be involved in the pathogenesis of schizophrenia. Recent genetic studies have revealed that the IL1 gene complex (IL,1 alpha, IL1, beta and IL1 receptor antagonist) wa...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2007.01671.x
更新日期:2007-08-01 00:00:00
abstract:AIM:This study examined catechol-O-methyltransferase (COMT) DNA methylation in the peripheral blood of schizophrenia patients and also in healthy controls to investigate its potential use as a peripheral biomarker of schizophrenia and its relations with the clinical variables of schizophrenia patients. METHODS:We exam...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12622
更新日期:2018-04-01 00:00:00
abstract::We investigated the mechanism of abnormal P300 findings in the patients with severe sleep apnea syndrome (SAS). Compared with controls, SAS patients showed significantly longer latency of P300. Not the mean sleep latency in multiple sleep latency test but the percentage of total periods in which percentage desaturatio...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2001.00844.x
更新日期:2001-06-01 00:00:00
abstract:AIMS:Psychiatric disorders and treatment with conventional antipsychotic medications have been associated with venous thromboembolism, but only a few data on recent antipsychotics such as olanzapine are available. METHODS:We describe four subjects treated with olanzapine who developed venous thromboembolism, and were ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2008.01899.x
更新日期:2009-02-01 00:00:00
abstract::At present, in the field of clinical epilepsy, it has been established that single proton emission computed tomography (SPECT) is useful for the regional determination of epileptic foci. In particular, it seems to be of great advantage to the field of clinical epilepsy that epileptic foci situation in the deep regions...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章,评审
doi:10.1111/j.1440-1819.1995.tb02171.x
更新日期:1995-06-01 00:00:00
abstract::MicroRNA may play a role in the pathophysiology of schizophrenia. A recent meta-analysis of genome-wide association studies indicated a significant association between schizophrenia and a common intronic variation in MIR137HG (microRNA 137 host gene) encoding the primary microRNA-137. To explore additional risk variat...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12047
更新日期:2013-05-01 00:00:00
abstract:AIM:In Japan, the government and media have become aware of the issues of early onset dementia (EOD), but policies for EOD have not yet been established and support systems are inadequate. To provide practical data about EOD, a two-step postal survey was performed. METHODS:A questionnaire requesting information on EOD...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12127
更新日期:2014-03-01 00:00:00
abstract:AIM:Psychiatric disorders are easily underestimated and under-recognized by physicians. The aim of the present study was to investigate the change in accuracy of recognizing psychiatric symptoms. METHODS:Consecutive 5-year consultation-liaison data were collected and patients with one of the five common psychiatric di...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2011.02272.x
更新日期:2011-12-01 00:00:00
abstract::The main purpose of the present study was to investigate the diagnostic concepts of taijin-kyofu-sho (TKS) and social phobia, by comparing the clinical diagnosis of TKS and the operational diagnosis of Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised; DSM-III-R). Three evaluators conducted s...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2002.01061.x
更新日期:2002-12-01 00:00:00
abstract::Psychological factors may be associated with the outcome of cancer treatment, including bone marrow transplantation (BMT). However, studies on the issue have provided controversial results. In the present study, effects of mood status on the outcome was studied through a follow-up period of 1-3 years as well as in sho...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2003.01084.x
更新日期:2003-02-01 00:00:00
abstract::Rapid eye movement sleep behavior disorder (RBD) is a parasomnia with clinical symptoms that include punching, kicking, yelling and leaping out of bed in sleep. Polysomnographic (PSG) finding showed REM sleep without muscle atonia. Clonazepam is generally used for treating RBD symptoms but melatonin was reported to be...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2001.00854.x
更新日期:2001-06-01 00:00:00
abstract::The objective of the present study was to analyze fractal structures of adult heart rate (HR) variability during a nap. Fractal analysis was carried out in one case over consecutive 10-min time series of HR, which were simultaneously recorded with electroencephalogram. Scaling relationships showed cross-over patterns ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2001.00814.x
更新日期:2001-06-01 00:00:00
abstract:AIMS:Antidepressants have been of limited use for adolescent subjects with depression because of drug-induced suicide-related events (SRE). Therefore, we investigated actual suicidality and its risk factors during antidepressant therapy among child and adolescent patients in clinical settings. METHODS:The risks of SRE...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2011.02204.x
更新日期:2011-04-01 00:00:00
abstract:AIM:Glial fibrillary acidic protein (GFAP), the intermediate filament protein expressed in astrocytes, plays a key role in many aspects of brain function through communication with neurons or blood vessels. A common single nucleotide polymorphism (SNP), GFAP -250 C/A (rs2070935), is associated with the transcriptional ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12932
更新日期:2020-01-01 00:00:00
abstract::The purpose of the present study was to test specific hypotheses regarding volumetric changes of the neocortex between 10 female trichotillomania (TTM) subjects and 10 female normal controls. A standard three-dimensional (3-D) brain coordinate system was imposed over each newly acquired native magnetic resonance imagi...
journal_title:Psychiatry and clinical neurosciences
pub_type: 临床试验,杂志文章
doi:10.1111/j.1440-1819.1997.tb03205.x
更新日期:1997-10-01 00:00:00
abstract::The functional promoter polymorphism -116C/G of the X-box binding protein 1 (XBP1) gene was found to be associated with schizophrenia in Han Chinese and Japanese subjects, although contradictive negative findings were also reported in European populations. To confirm this association in a Japanese population, the auth...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2006.01570.x
更新日期:2006-10-01 00:00:00
abstract:AIMS:The purpose of this study was to examine the usefulness of near-infrared spectroscopy (NIRS) for identifying abnormalities in prefrontal brain activity in children with autism spectrum disorders (ASD) as they inferred the mental states of others. METHODS:The subjects were 16 children with ASD aged between 8 and 1...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12052
更新日期:2013-05-01 00:00:00
abstract:AIM:Prescription opioids are psychoactive substances that can elicit many neuropsychological effects. There are no studies that directly demonstrate the effects of prescription opioid addiction (POA) on the human brain. This study aimed to quantify γ-aminobutyric acid (GABA) and glutamate (Glu) levels in the prefrontal...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12940
更新日期:2020-01-01 00:00:00
abstract::A patient with atypical multiple sclerosis (MS) with clear concentric structure was studied using high field magnetic resonance imaging (MRI). This case was considered to be Baló's concentric sclerosis. Magnetic resonance imaging showed diffuse multiple concentric demyelinating lesions in the bilateral centrum semiova...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.1996.tb01661.x
更新日期:1996-02-01 00:00:00
abstract::Oxytocin (OT), often called the 'hormone of love' or 'hormone of attachment,' plays a fundamental role in the establishment and quality of parent-infant bonding. However, emerging evidence indicates that OT can also produce antisocial behavior. To clarify these effects, we review studies examining the role of endogeno...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章,评审
doi:10.1111/pcn.12544
更新日期:2017-10-01 00:00:00
abstract::A female patient exhibiting functional hearing loss in her left ear demonstrated reduced amplitude of P3 component in event-related potentials (ERP) to left monaural stimulation, with preserved N1 and N2 components to stimulation of either ear. This result suggested that stimuli in the affected ear were conducted succ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.1996.tb01668.x
更新日期:1996-04-01 00:00:00
abstract:AIMS:This paper examines the relationship between observational behavior and the observers' result assumptions, using a contained diagram that includes significant non-verbal information, such as gestures. The ability of care workers to assess a patient's mental status on the basis of non-verbal information would be co...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2010.02077.x
更新日期:2010-06-01 00:00:00
abstract::Sporadic temporal slow waves are considered to be associated with mild cerebrovascular dysfunction. However, electroencephalogram (EEG) changes have not been consistently described by some investigators and correlations inferred on the basis of such data remain inconclusive. In the present study, we examined previousl...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2001.00900.x
更新日期:2001-10-01 00:00:00
abstract::It is well known that various perceptual abnormalities exist in autism. However, because perceptual phenomena are intersubjective, a phenomenological approach is required for getting hold of the reality of the modes of perception involved in autism. From this standpoint, the author has proposed the concept of 'percept...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.1998.00460.x
更新日期:1998-12-01 00:00:00
abstract:AIM:We compared the 1-year rehospitalization rates of first-episode bipolar manic patients who were discharged while being treated with lithium or valproate in combination with an atypical antipsychotic. METHODS:We investigated the rehospitalization status of first-episode bipolar manic patients who were discharged be...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12145
更新日期:2014-06-01 00:00:00
abstract::Atypical antipsychotics are rapidly evolving to become the standard pharmacotherapy in schizophrenia; however, the trend of switching to such drugs is not necessarily progressing quickly in East Asia. This might be due to the scarcity of evidence for the efficacy of switching from conventional to atypical antipsychoti...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2006.01591.x
更新日期:2006-12-01 00:00:00
abstract::The outcome of first-admission schizophrenic patients at Jichi Medical School Hospital was investigated to identify outcome predictors of schizophrenia among the symptoms at the time of the first hospitalization. The subjects were 62 schizophrenic patients, 29 females and 33 males, consecutively discharged from the De...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2004.01301.x
更新日期:2004-10-01 00:00:00