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:AIM:Auditory mismatch negativity (MMN) and its magnetoencephalographic (MEG) counterpart (MMNm) are an established biological index in schizophrenia research. MMN in response to duration and frequency deviants may have differential relevance to the pathophysiology and clinical stages of schizophrenia. MEG has advantage...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12397
更新日期:2016-07-01 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::Twenty-four community residing elderly people in need of care, who were registered with the municipal welfare center in Miyagi Prefecture, Japan, and their principal caregivers participated in the study. The principal caregivers completed a self-administered questionnaire involving their demographic status, provided d...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.1998.00418.x
更新日期:1998-08-01 00:00:00
abstract::A new mathematical method was developed to analyze time series. Applications of this method to the delta component of all-night sleep electroencephalogram (EEG) revealed new variations with double-rapid eye movement (REM)-sleep interval. The proposed method entails repeated application of the least squares spectrum. F...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.1998.00450.x
更新日期:1998-10-01 00:00:00
abstract::The aim of the present study was to evaluate the validity of mixed anxiety and depressive disorder (MADD) with reference to functional characteristics and symptomatic characteristics in comparison with anxiety disorders, depressive disorders, and groups showing subthreshold symptoms (exclusively depressive or anxiety ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2006.01482.x
更新日期:2006-04-01 00:00:00
abstract::An autopsy case of malnutrition with spinal tract degeneration confined to the bilateral posterior columns is reported. The patient had schizophrenia in adolescence, and suffered from aplastic anemia in late middle age. Subsequently, he took little food due to delusions for 18 months until his death. He had malnutriti...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.1995.tb01862.x
更新日期:1995-03-01 00:00:00
abstract:AIMS:Suicide is a leading cause of death among Japanese college and university students. Gatekeeper-training programs have been shown to improve detection and referral of individuals who are at risk of suicide by training non-mental-health professional persons. However, no studies have investigated the effectiveness of...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12358
更新日期:2016-01-01 00:00:00
abstract::The purpose of the present study was to explore the suicidal ideation of community-dwelling elderly and the factors associated with their intention to commit suicide. Using a multilevel stratified sampling strategy, 1000 elderly subjects were recruited (aged 65-74 years old) in Taiwan during the year 2001. The degree ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2005.01387.x
更新日期:2005-08-01 00:00:00
abstract::To study course and outcome of Bipolar II disorder, 217 major depressive episode (MDE) patients were interviewed with Structured Clinical Interview for DSM-IV. Patients with more than three MDE and patients with fewer MDE were compared. Patients with more than three MDE were 77.8%. Comparisons, controlled for confound...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2001.00786.x
更新日期:2001-02-01 00:00:00
abstract::Telemedicine is the provision of professional medical services from sites removed from the patient. This study was conducted in order to assess the reliability of psychiatric evaluations via video-consultation. The inter-rater reliability was determined for each interviewing condition by employing the reliability-test...
journal_title:Psychiatry and clinical neurosciences
pub_type: 临床试验,杂志文章
doi:10.1046/j.1440-1819.2000.00637.x
更新日期:2000-02-01 00:00:00
abstract::Oxygen saturation was measured in 37 patients with sleep-related breathing disorders over 2 nights: after alcohol intake and under control conditions. Both the number of 3% oxygen desaturation per hour (ODI3) and the lowest saturation (LSAT) were significantly aggravated after alcohol ingestion. Oxygen saturation was ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2000.00701.x
更新日期:2000-06-01 00:00:00
abstract::Subjective sleep feelings and motor activity were measured in seven healthy elderly subjects for 6 days. The subjects were exposed to bright light (6000 lux) for 30 min in the morning or instructed to sit in front of a desktop lighting device without light. The average level of motor activity during the night was sign...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.1998.tb01059.x
更新日期:1998-04-01 00:00:00
abstract::The aim of the present study was to investigate the effects of a group structured intervention on the mental and physical discomfort and immune function of 20 family caregivers. A structured intervention for caregivers consists of five sessions, each of which lasts 90 min. This was a modified version of the program th...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2003.01094.x
更新日期:2003-04-01 00:00:00
abstract::The purpose of the present study was to investigate the neural substrates underlying event-related potential (ERP) abnormalities, with respect to the generators of the ERP components in depressed patients. Using an oddball paradigm, ERP from auditory stimuli were recorded from 22 unmedicated patients with current depr...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2004.01195.x
更新日期:2004-02-01 00:00:00
abstract::Night-time bright light (BL) treatment and triazolam (0.125 mg/day) were given to three healthy elderly people in a cross-over design. They kept a daytime sleepiness test and a sleep log, and their wrist-activity was monitored simultaneously. Subjectively, BL increased daytime sleepiness and naps, and decreased night-...
journal_title:Psychiatry and clinical neurosciences
pub_type: 临床试验,杂志文章
doi:10.1046/j.1440-1819.2000.00721.x
更新日期:2000-06-01 00:00:00
abstract::A medium-sized portable digital recorder with fully integrated circuit (IC) memories for sleep monitoring has been developed. It has five amplifiers for EEG, EMG, EOG, ECG, and a signal of body acceleration or respiration sound, four event markers, an 8 ch A/D converter, a digital signal processor (DSP), 192 Mbytes IC...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.1999.00526.x
更新日期:1999-04-01 00:00:00
abstract::We describe the test-retest reliability of the Personality Diagnostic Questionnaire: Revised (PDQ-R), which was developed to assess DSM-III-R personality disorders (PD). Thirty patients, diagnosed clinically with PD, filled out the PDQ-R twice at 1 month intervals after having undergone 8 weeks of treatment leading to...
journal_title:Psychiatry and clinical neurosciences
pub_type: 临床试验,杂志文章
doi:10.1111/j.1440-1819.1997.tb02601.x
更新日期:1997-12-01 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
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:AIM:Rare variations are suggested to play a role in the genetic etiology of schizophrenia; to further investigate their role, we performed a three-stage study in a Japanese population. METHODS:In the first stage, we performed whole-exome sequencing (WES) of two parent-affected offspring trios. In the second stage, we ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12526
更新日期:2017-08-01 00:00:00
abstract::Obstructive sleep apnea syndrome (OSAS) is a significant problem for some patients presenting with snoring and excessive daytime sleepiness. The 'golden standard' therapy in OSAS is considered to be nasal continuous positive airway pressure (CPAP). The effects of CPAP on work performance in sleep apnoics has not been ...
journal_title:Psychiatry and clinical neurosciences
pub_type: 临床试验,杂志文章
doi:10.1046/j.1440-1819.1999.00625.x
更新日期:1999-12-01 00:00:00
abstract::The present study was purposed to identify the prevalence of restless legs syndrome (RLS) and its associated factors in the Korean adult population. Among a total of 9939 participants derived from the Korean Health and Genome Study, 12.1% of subjects (men, 8.5%; women, 15.4%) suffered from RLS. Factors independently r...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2005.01381.x
更新日期:2005-06-01 00:00:00
abstract:AIM:It is difficult to diagnose dementia with Lewy bodies (DLB) because it exhibits clinical and neuropathological overlap with both Alzheimer's disease and Parkinson's disease. The α-synuclein protein is a major component of Lewy bodies, and accumulation of α-synuclein aggregates causes synaptic dysfunction in DLB. Ep...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/pcn.12462
更新日期:2017-01-01 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::The purpose of the present paper was to clarify the link between the attention and arousal level that supports the basis of the cognitive dysfunction in schizophrenia, by investigating the relationship between the simple reaction time and the closed-eye eye movements in 30 patients with schizophrenia and 20 healthy co...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1046/j.1440-1819.2003.01150.x
更新日期:2003-10-01 00:00:00
abstract::A high disease burden of mental disorders has been noted worldwide, including Japan. It is important to monitor mental disorder prevalence trends and the use of mental health services over time using epidemiological data and to plan appropriate policies and measures that consider mental health in each country. This re...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章,评审
doi:10.1111/pcn.12894
更新日期:2019-08-01 00:00:00
abstract::Several countries, such as the USA, inadvertently created a different behavioral health payment system from the rest of medicine through the introduction of diagnostic-related group exemptions for psychiatric care. This led to isolation in the administration and delivery of care for patients with mental health and sub...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章,评审
doi:10.1111/j.1440-1819.2006.01500.x
更新日期:2006-06-01 00:00:00
abstract::The present study was aimed to clarify the differences in clinical implications between wrist- and arm-cutting. Subjects were 201 delinquent adolescents (178 males and 23 females) who had been admitted to a detention center from February to March 2003. A self-reporting questionnaire and the Adolescent Dissociative Exp...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章
doi:10.1111/j.1440-1819.2004.01271.x
更新日期:2004-08-01 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 authors reviewed the literature on the pharmacotherapy of geriatric mood disorders. Based on the evidence available, we have proposed: (i) that although any antidepressant is assumedly equal in antidepressive efficacy, ones with weak anticholinergic and antialpha1 effects are preferable in geriatric patients; (ii)...
journal_title:Psychiatry and clinical neurosciences
pub_type: 杂志文章,评审
doi:
更新日期:1999-10-01 00:00:00