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Decision making

What is ‘decision making’ referring to? 

Decision making requires an individual to use their knowledge and experience of a context in order to choose a course of action. A person’s ability to autonomously make decisions is referred to as their decisional capacity. Effective decision making aims to increase the likelihood of a favourable outcome in the relevant context. People with schizophrenia may show altered decision-making processes and impairments in their capacity to provide informed consent to medical or psychiatric treatment. People with impaired decisional capacity may not be able to understand information relating to the decision; appreciate the significance of the information and apply the information to decision-making; reason and compare potential consequences of the decision in a logical process; and/or communicate this decision. Decision making and decisional capacity may be associated with other areas of cognitive functioning, with a certain level of mental functioning required to make the most appropriate decisions in the situation.

What is the evidence for decision making?

Moderate to low quality evidence suggests people with schizophrenia are more likely to make decisions with disadvantageous consequences than people without schizophrenia. This effect is greater in people receiving second generation antipsychotics, and in people with catatonic, psychotic, or negative symptoms. Impaired understanding and appreciation of information regarding consent to treatment and research is associated with more severe psychopathology, particularly negative symptoms.


April 2016

Page last updated: 3:58  6 September 2017

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