ArticleSocial psychiatry and psychiatric epidemiology2025
The RECAPACITA PROJECT: comparative study of the clinical, neuropsychological, and functional profile of people with severe mental disorder and partial and total capacity modification.
Article in Social psychiatry and psychiatric epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvaluating the decision-making capacity of individuals with Severe Mental Disorder (SMD) is essential for compliance with the 2006 Convention on the Rights of People with Disabilities. In Spain, capacity was historically determined through judicial procedures, resulting in partial or total capacity modification (CM). The abolition of this procedure in 2021 has left a gap in addressing the needs of this population, creating challenges under the new legal framework.
aimThe RECAPACITA project studied the clinical, neuropsychological, and functional profiles of individuals with SMD and CM, focusing on differences between partial (pCM) and total (tCM) modifications.
methodsA cross-sectional study was conducted with 77 adult patients with SMD and CM (47 tCM, 30 pCM) from the Parc Sanitari Sant Joan de Déu mental health network (Spain). Sociodemographic, clinical, functional, and neuropsychological data were collected, along with an independent assessment of mental capacity.
resultsAround 87% of sample had a schizophrenia spectrum disorder; pCM patients presented more substance-related and personality disorders as a secondary diagnosis. While no statistically significant differences were observed between groups, clinically, tCM group presents greater clinical alteration, lower insight, sustained attention, coding capacity, processing speed and resistance to interference compared to pCM group. tCM group had worse social functioning, and lower scores in reasoning and appreciation when assessing mental capacity.
conclusionsIndividuals with tCM show greater clinical impairment and higher support needs compared to those with pCM. With the practical and legal abolition of tCM, it is essential to ensure that these individuals' persistent challenges are adequately addressed, as their needs remain significant despite the disappearance of this legal category.
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