Capacity to consent to treatment in patients with acute mania

AIMS AND METHOD This study aimed to determine the proportion of patients hospitalised with mania who had capacity to consent to treatment, to determine the predictors of capacity and to explore the relationship between detained status and capacity. Fifty in-patients with mania participated in a clinical interview to assess capacity. RESULTS Nineteen patients (38%) had overall capacity. Capacity was predicted by higher IQ, lower severity of manic symptoms and more episodes of depression; it was not related to voluntary or detained status. The domains of capacity were not hierarchical. CLINICAL IMPLICATIONS Many patients hospitalised with mania have capacity to make an informed choice regarding treatment even when compulsorily detained. Their capacity should be reviewed frequently and measures adopted to enhance capacity.