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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.
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.
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.
As ‘genetics’ pertains to the study of genes and their characteristics, so ‘genomics’ refers to the study of the entire genetic complement (the genome) of organisms and their constituent cells. More importantly, the term genomics encompasses the experimental analysis of the expression patterns of the genes of an organism, with the aim of an improved understanding of how important biological processes are regulated. This has led to the concept of ‘gene profiling’ or ‘transcript profiling’, which essentially is the quantitative analysis of many different gene transcripts simultaneously. The ability to perform this type of analysis, together with the availability of sequence information from many thousands of genes from a number of organisms (and often the gene clones themselves), offers an enormous potential benefit to many areas of investigative biology.
Not least is the area of toxicology, where the term ‘toxicogenomics’ is now becoming widely used. Of the number of important potential benefits offered by the application of genomics to toxicology, perhaps the most significant are: (i) the construction of a large database of gene expression information linked to toxic endpoints, and (ii) a more detailed understanding of the molecular mechanisms of compound toxicity. Strategic application of this information should result in the development of more rapid, mechanism-based screens for toxicity.
Biomarkers in toxicology
The development and use of biomarkers in toxicology is becoming widespread, specifically in the areas of exposure monitoring, and the determination of response and susceptibility to toxins (see  for review).