Neuropsychological Impairment Corresponds with Poor Understanding of Informed Consent Disclosures in Persons Diagnosed with Major Depression

Incapacity to make decisions about medical treatment is associated with neuropsychological impairment in a variety of illnesses. Although cognitive deficits occur often in people with major depressive illness, little research has studied its association with decisional capacity. The present investigation examined ability to understand treatment disclosures, which is a core component of decisional capacity, in 31 inpatients with depression and 16 normal controls. Depressed inpatients with diminished neuropsychological function showed poor understanding of treatment disclosures compared to the control group. Nonetheless, with sufficient cueing, depressed inpatients with diminished neuropsychological function were able to display understanding that was equivalent to the control group. Exploratory regression analyses revealed that diminished new-learning correlated with poorer understanding. Implications of these results for clinical practice and medical research involving people with major depressive illness are discussed.