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P02-72 - Clinical Assessment of Competence to Consent to Sexual Activity in Bipolar Disorder and Schizophrenic Spectrum Disorders. A Preliminary Study

Published online by Cambridge University Press:  17 April 2020

G. Mandarelli
Affiliation:
Department of Psychiatric Sciences and Psychological Medicine, Rome, Italy
S. Zangaro
Affiliation:
Department of Neuroscience, Mental Health and Sensory Organans, Sapienza University of Rome, Rome, Italy
A. Azzoni
Affiliation:
Servizio Psichiatrico di Diagnosi e Cura, S.Spirito Hospital, Rome, Italy
M. Raja
Affiliation:
Department of Neuroscience, Mental Health and Sensory Organans, Sapienza University of Rome, Rome, Italy
R. Tatarelli
Affiliation:
Department of Neuroscience, Mental Health and Sensory Organans, Sapienza University of Rome, Rome, Italy
S. Ferracuti
Affiliation:
Department of Neuroscience, Mental Health and Sensory Organans, Sapienza University of Rome, Rome, Italy

Abstract

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Objectives

To develop a clinician-oriented semi-structured interview for the assessment of sexual consent: the Sexual Consent Competency Assessment Scale (SCAS). To assess sexual consent competence in a sample of hospitalized patients, affected by bipolar disorder (BD) and schizophrenic spectrum disorders (SSD, schizophrenia or schizoaffective disorder).

Methods

Patients were recruited at the Psychiatric ward of S. Spirito Hospital, Rome and diagnosed according to DSM-IV-TR criteria. The SCAS items were derived and adapted from Kennedy et al. (Am J Ment Retard 2001;106:503-510). The scale items were directly rated by 2 independent clinicians, on a 3-point Likert Scale corresponding to 3 possible outcomes: capable, marginally capable or incapable. Internal consistency, test-retest and inter rater-reliability were good. Principal component factor analysis (PCA) with varimax rotation was applied.

Results

Fifty-four BD patients (51.9% females) and 31 SSD patients (71.0% females) were recruited (mean age, years: 38.1±13.4; 38.4±9.7 respectively; p=0.91). BD patients had better sexual consent competence compared to SSD, there were no gender differences. Cognitive functioning as measured by the Raven Progressive Matrices appeared to moderate the relationship between diagnostic group and sexual consent decisional capacity, with better scores corresponding to higher competence. PCA revealed two interpretable factors 1) cognitive-emotional and 2) consequences-prevention. There were no significant group differences between BP and SSD in the second factor.

Conclusion

The SCAS proved good psychometric validity and reliability. Patients with bipolar disorder showed better sexual consent competence compared to schizophrenic spectrum disorders.

Type
Forensic psychiatry
Copyright
Copyright © European Psychiatric Association 2010
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