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

Published online by Cambridge University Press:  02 January 2018

Isis F.F.M. Elzakkers ,
Unna N. Danner ,
Hans W. Hoek  and
Annemarie A van Elburg
Isis F.F.M. Elzakkers*
Affiliation:
Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
Unna N. Danner
Affiliation:
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
Hans W. Hoek
Affiliation:
Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands Department of Social Sciences, Utrecht University, Utrecht, The Netherlands
Annemarie A van Elburg
Affiliation:
Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
*
Isis F.F.M. Elzakkers, MD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Wenshoek 4, 3705 WE, Zeist, The Netherlands. Email: i.elzakkers@altrecht.nl
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Abstract

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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.

Type
Research Article
Information
BJPsych Open , Volume 2 , Issue 2 , March 2016 , pp. 147 - 153
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Copyright
Copyright © The Royal College of Psychiatrists 2016

Footnotes

Declaration of interest

None.

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