Decisional capacity of severely depressed patients requiring electroconvulsive therapy

Maria I. Lapid, Teresa A. Rummans, Kristine L. Poole, V. Shane Pankratz, Megan S. Maurer, Keith G. Rasmussen, Kemuel L. Philbrick, Paul S. Appelbaum

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Objective: The decisional capacity of severely depressed people frequently comes into question. The ability to improve this decisional capacity through educational efforts alone is not known. Our study aimed to determine the decisional capacity of severely depressed people requiring electroconvulsive therapy (ECT), and whether educational interventions improve their ability to provide informed consent for ECT. Materials and Methods: Forty subjects with severe depression were recruited. Using the MacArthur Competence Assessment Tool for Treatment instrument, decisional capacity was assessed at baseline and reassessed after education. All of the subjects received standard education. Additionally, half were blindly randomized to receive an experimental educational intervention. Results: At baseline, there was no statistical difference in the decisional capacity between the standard and experimental intervention groups. After educational interventions, all four areas of decisional capacity improved for both groups (understanding p < 0.001, reasoning p < 0.001, appreciation p = 0.031, choice p = 0.006). However, there was no measurable additional improvement in scores for those randomized to receive additional education. Conclusion: Our findings indicate that this group of severely depressed people had good decisional capacities to give informed consent. Education improved their decisional capacity. There is an endpoint beyond which additional educational intervention does not result in measurable improvement in decisional capacity.

Original languageEnglish (US)
Pages (from-to)67-72
Number of pages6
JournalJournal of ECT
Issue number2
StatePublished - Jun 18 2003


  • Decisional capacity
  • Depression
  • Electroconvulsive therapy
  • Informed consent

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Psychiatry and Mental health


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