Résumé
Background: patients with schizophrenia have impaired capacity to consent to psychotropic treatment, as demonstrated by numerous studies. At the same time, in the context of the COVID-19 health crisis, the question of the acceptability of vaccines by the general population has arisen. This question is even more acute for patients with psychotic disorders, who constitute a fragile and vulnerable population.Objectives: to compare the capacity to consent to COVID-19 vaccination and the capacity to consent to psychotropic treatment for the same population with psychotic disorders and to investigate a possible link between the two.Participants: 27 patients with psychotic disorders recruited from the Montpellier University Hospital (adult psychiatry units of the Colombière hospital and the Hauts de Massane medico-psychological center).Methods: participants' capacity to consent was assessed with the MacCAT-T questionnaire translated and validated in French. Cognitive abilities were assessed with the MoCA test. The severity of psychotic symptomatology was assessed with the PANSS.Results: we do not find a statistically significant association between capacity to consent to COVID-19 vaccination and capacity to consent to antipsychotic treatment. Among patients with diminished capacity to consent to antipsychotic treatment, a significant proportion retain the capacity to consent to COVID-19 vaccination.Conclusions: one cannot prejudge a patient's capacity to consent solely on the basis of a diagnosis of psychotic disorder. This assessment must therefore remain an individualized process and consent must be systematically sought in the most rigorous way possible through a reinforced interview. Further studies are needed to optimize this approach with a larger number of patients.