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A systematic review of the literature about competence and poor insight.
MedLine Citation:
PMID:  21902676     Owner:  NLM     Status:  Publisher    
Ruissen AM, Widdershoven GAM, Meynen G, Abma TA, van Balkom AJLM. A systematic review of the literature about competence and poor insight. Objective:  Formally, incompetence implies that a patient cannot meet the legal requirements for informed consent. Our aim was to review the scientific literature on the relationship between competence and insight in patients with psychiatric disorders, how competence and insight are connected in these patients and whether there are differences in competence and insight among patients with different disorders. Method:  A search in PubMed/Medline was performed. Articles were assessed on relevance criteria by two independent reviewers. Study design, population, variables, and outcomes were extracted. Results:  Seven articles were included on studies of psychiatric inpatients and outpatients and of psychotic and non-psychotic patients. All studies used the MacArthur Competence Assessment Tool (MacCAT). All studies but one found a strong correlation between poor insight and incompetence. Psychotic patients with poor insight are very likely to be incompetent, and psychotic patients with adequate insight are generally competent. One well-executed study showed that in non-psychotic disorders, however, another relationship emerges; competence and insight do not completely overlap in these patients. Conclusion:  Most incompetent psychotic patients have poor insight, but non-psychotic patients with adequate insight were incompetent in a substantial number of cases. In sum: non-psychotic patients with adequate insight can be incompetent.
A M Ruissen; G A M Widdershoven; G Meynen; T A Abma; A J L M van Balkom
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-8
Journal Detail:
Title:  Acta psychiatrica Scandinavica     Volume:  -     ISSN:  1600-0447     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370364     Medline TA:  Acta Psychiatr Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 John Wiley & Sons A/S.
VU University Medical Centre, Medical Humanities, EMGO+ Institute for Health and Care Research, Amsterdam GGZ inGeest, Department of Psychiatry, Amsterdam VU University Amsterdam, Faculty of Philosophy, Amsterdam VU University Medical Centre, Department of Psychiatry, EMGO+ Institute for Health and Care Research, Amsterdam, the Netherlands.
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