Decisional and Dispositional Capacity Determinations: Neuropsychiatric Illness and an Integrated Clinical Paradigm

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Decisional capacity assessment involves reviewing psychiatric symptoms and cognitive processes.
• Capacity for self-management post-discharge is distinct from general decisional capacity.

Purpose of the Study:

• To review literature on decisional capacity and dispositional capacity.
• To propose standardized guidelines for capacity determinations.

Main Methods:

• Literature review of neuropsychiatric illnesses and impaired decisional capacity.
• Exploration of the term "dispositional capacity" in clinical literature.

Main Results:

• Neurocognitive and neurologic disorders frequently impair decisional capacity.
• "Dispositional capacity" was not found in existing literature; no guidelines were identified.

Conclusions:

• Routine cognitive assessment is recommended for decisional capacity evaluations.
• Introduced "dispositional capacity" as a new subtype for self-management assessment.
• Proposed guidelines for a biopsychosociocultural approach to capacity determination.