Past Issues

Objectives: Inconsistent results exist about which domain of psychopathology,
i.e, positive or negative symptoms affects the decision-making capacity to consent
to clinical research (DMC) most in patients with schizophrenia spectrum disorders
(SSD). The current study was to explore this topic using a regression model
controlling for related covariates. Methods: All 177 patients with schizophrenia or
schizoaffective disorders were assessed with the MacArthur Competence Assessment
Tool for Clinical Research (MacCAT-CR), the Positive and Negative Syndrome
Scale, and other measures. We used a linear regression model to fi nd the
association between psychotic symptoms and MacCAT-CR. Results: The mean
age of subjects was 51.4 years. The majority of subjects were male (68.9%). The
mean duration of schizophrenia and hospitalization were 27.9 years and 15.1 years,
respectively. Negative symptoms were found to be signifi cantly to have negative
association with appreciation (B = -0.06, t = -2.27, p < 0.05) and reasoning scores
(B = -0.09, t = -2.65, p < 0.01). Some components of MacCAT-CR scores were
signifi cantly to have positive association with educational years (p < 0.01), cognitive
function (p < 0.01), male sex (p < 0.05), and negative association with the
length of stay (p < 0.05). Conclusion: The most central fi nding of this study was
that SSD patients with severe negative symptoms performed poorly on DMC. Beside,
females, those with longer length of stay, lower educational level, and cognitive
defi cit were associated with impaired DMC. Those fi ndings suggest that study
investigators and institutional review boards should consider more intensive surveys
for SSD patients with risk factors for impaired DMC and administer educational
interventions to improve capacities to make decisions in the process of
recruitment.