ABSTRACT
The appearance of the SARS CoV-2 virus and the associated COVID-19 pandemic has been associated with the onset of mental disorders in healthy people and the worsening in those with pre-existing mental conditions. One of the areas that has raised the greatest concern is that of suicidality. Most of the published studies have been carried out cross-sectional or with small samples, without stratifying by age and gender. Thus, the aim of this longitudinal research is to study, in a large population sample of around 6,700,000 inhabitants belonging to the entire region of Madrid (Spain), the admissions in psychiatric hospitalization units due to suicidal attempts along 2019, 2020 and 2021. No clear increase in the number of admissions due to suicidality in the total population have been found. In addition, a higher prevalence in admissions among women is verified. Moreover, stratifying by age and gender, a striking and significant increase in hospital admissions due to suicidality has been observed in the group up to 17 years old, from September 2020 until the end of the study. These results highlight the special vulnerability of children and adolescents, specifically girls, and the need for preventive measures in the face of future pandemics.
Subject(s)
COVID-19 , Suicide, Attempted , Adolescent , Child , Humans , Female , Suicide, Attempted/psychology , Pandemics , Longitudinal Studies , Cross-Sectional Studies , Suicidal Ideation , Hospitalization , HospitalsABSTRACT
The aim of the study was to assess a Spanish adaptation of a method that determines the categorical capacity status of potential participants in research projects. The sample consisted of 120 subjects (40 general medicine inpatients, 40 psychiatric inpatients, and 40 healthy controls). The MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) interview and Mini-Mental State Examination (MMSE) were used. A feasibility study was carried out and reliability and validity calculations were made against the expert-judgment gold standard. The mean duration of the MacCAT-CR was 13 min. For the MacCAT-CR understanding, appreciation, reasoning, and expressing a choice subscales, the intraclass coefficient correlation (interrater reliability) was .93, .88, .90, and .50, respectively, and internal consistency (Cronbach's alpha) was .96, .94, and .95, respectively. Patients considered to be incompetent for expert-judgment obtained lower scores in the MacCAT-CR interview. The Spanish version of the MacCAT-CR is feasible, reliable, and valid for assessing the capacity of patients to give consent in research.
Subject(s)
Biomedical Research/ethics , Decision Making , Informed Consent/psychology , Language , Mental Competency , Psychological Tests/standards , Adult , Aged , Aged, 80 and over , Comprehension , Ethics, Research , Feasibility Studies , Female , Humans , Male , Middle Aged , Psychometrics , Reproducibility of Results , Spain , Translating , Young AdultABSTRACT
Fundamento y objetivo: Validar al español la entrevista MacArthur Competence Assessment Tool for Treatment (MacCAT-T), que valora la capacidad de los pacientes para consentir tratamiento examinando 4 áreas (comprensión, apreciación, razonamiento y expresión de una elección). Pacientes y método: La muestra se componía de 160 sujetos (80 ingresados en Medicina Interna, 40 ingresados en Psiquiatría y 40 controles sanos). Se utilizaron los instrumentos MacCAT-T y Mini-Mental State Examination (MMSE). Se llevó a cabo un estudio de factibilidad, cálculo de fiabilidad y validez (contragold standard del experto clínico). Resultados: La duración media de la entrevista MacCAT-T fue de 18 min. Respecto a la fiabilidad interobservador, el coeficiente de correlación intraclase fue para Comprensión = 0,98, Apreciación = 0,97, Razonamiento = 0,98 y Expresión de una elección = 0,91. La consistencia interna (alfa de Cronbach) fue: Comprensión = 0,87, Apreciación = 0,76 y Razonamiento = 0,86. Los pacientes considerados incapaces (gold standard) obtienen puntuaciones menores en todas las áreas de la MacCAT-T. Un rendimiento bajo en la MacCAT-T se relaciona con el deterioro cognitivo evaluado por MMSE. Conclusiones: La versión española de la MacCAT-T es fiable, factible y válida para la evaluación de la capacidad de los pacientes para consentir tratamiento (AU)
Background and objective: To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice). Patients and method: Sample: 160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls). Instruments: MacCAT-T, Mini-Mental Status Examination (MMSE). Procedure: Feasibility study, reliability and validity calculations (against to gold standard of clinical expert). Results: Mean duration of the MacCAT-T interview was 18 min. Inter-rater reliability: Intraclass correlation coefficient for Understanding = 0.98, Appreciation = 0.97, Reasoning = 0.98, Expressing a choice = 0.91. Internal consistency (Cronbachs alpha): Understanding = 0.87, for Appreciation = 0.76, for Reasoning = 0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE. Conclusions: Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment (AU)
Subject(s)
Humans , Informed Consent/statistics & numerical data , Decision Making , Psychometrics/instrumentation , Reproducibility of Results , Patient Compliance , Case-Control Studies , Mental Disorders/therapyABSTRACT
BACKGROUND AND OBJECTIVE: To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice). SAMPLE: 160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls). INSTRUMENTS: MacCAT-T, Mini-Mental Status Examination (MMSE). PROCEDURE: Feasibility study, reliability and validity calculations (against to gold standard of clinical expert). RESULTS: Mean duration of the MacCAT-T interview was 18min. Inter-rater reliability: Intraclass correlation coefficient for Understanding=0.98, Appreciation=0.97, Reasoning=0.98, Expressing a choice=0.91. Internal consistency (Cronbach's alpha): Understanding=0.87, for Appreciation=0.76, for Reasoning=0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE. CONCLUSIONS: Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment.
