RECAPACITA project: Comparing neuropsychological profiles in people with severe mental disorders, with and without capacity modification

• Published in: International journal of law and psychiatry 2024-11, Vol.97, p.102035, Article 102035
• Main Authors: Silvia, Marcó-García, Georgina, Guilera, Marta, Ferrer-Quintero, Susana, Ochoa, Gemma, Escuder-Romeva, Elena, Rubio-Abadal, Arantxa, Martínez-Mondejar, Núria, del Cacho, Vanessa, Montalbán-Roca, Ana, Escanilla-Casal, Sol, Balsells-Mejía, Elena, Huerta-Ramos
• Format: Article
• Language: English
• Subjects: Adult; Assessment; Cognition; Cross-Sectional Studies; Decision Making; Decision-making capacity; Executive Function; Female; Humans; Legislation; Male; Mental capacity; Mental Competency - psychology; Mental disease; Mental Disorders - psychology; Middle Aged; Neuropsychological Tests; Schizophrenia; Spain
• ISSN: 0160-2527; 1873-6386; 1873-6386
• DOI: 10.1016/j.ijlp.2024.102035

Mental capacity assessment plays a crucial role in decision-making, especially in psychiatric contexts, where legal frameworks for determining capacity vary widely. This study explores the relationship between cognitive functioning and decision-making capacity modification (CM) in severe mental disorders (SMD), shedding light on the importance of neuropsychological evaluation in CM processes. Cross-sectional descriptive study, with 77 adult patients with SMD and CM, and 33 without CM from the mental health sector of Parc Sanitari Sant Joan de Déu (Spain). CM, sociodemographic and neuropsychological data were collected. An independent brief assessment of patients' mental capacity was also evaluated. There is an overrepresentation of males in CM processes. All three groups exhibit mild multidomain dysfunction, with impairments in executive functions, memory, and processing speed. Individuals with CM show poorer verbal learning capacity, with an impact on their occupational and family functioning. Mnemonic encoding positively correlates with mental capacity to decide, suggesting it could preliminarily be considered a potential predictive marker in CM processes. This study contributes insights into the cognitive aspects of CM in SMD, underscoring the need for a comprehensive approach integrating clinical, cognitive, and social factors in assessing decision-making capacity in this population. •Men are overrepresented in severe mental disorders (SMD) and capacity modification (CM), highlighting factors contributing to higher CM inmales.•All groups show mild executive dysfunction, impacting various cognitive functions essential for daily functioning.•Individuals with CM exhibit poorer verbal learning capacity, affecting their occupational and family functioning.•Verbal codification correlates with mental capacity to decide, suggesting its role as a potential marker in CM processes.•A holistic assessment considering clinical, cognitive, and social factors is crucial for addressing decision-making capacity in SMD patients.