A comparison of patients who refuse and consent to neuroleptic treatment

A recently enacted regulation in California requires that voluntary mental patients give signed informed consent for treatment with antipsychotic drugs. To evaluate the law's effects on schizophrenic patients, the authors compared 15 patients who refused to give consent with a matched group of 15 who gave consent. Refusers had significantly higher scores on the Brief Psychiatric Rating Scale for conceptual disorganization, emotional withdrawal, and unusual thought content. They were also more hostile, uncooperative, and mistrustful of the treatment team and more likely to believe they were not ill. The authors raise questions regarding the most appropriate consent process for schizophrenic patients.