A Preliminary Application of Interpersonal Psychological Theory on Suicidal Soldiers in Taiwan
摘要
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 find 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 significantly 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 significantly 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 finding 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 deficit were associated with impaired DMC. Those findings 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.