The purpose of this secondary analysis of an archival sample of 100 Canadian men remanded for evaluations of fitness to stand trial was to investigate the relationships among fitness, competence to make treatment decisions, and psychosis. As hypothesized, competence to make treatment decisions was more often impaired in those with impaired fitness. Among unfit defendants, a diagnosis of a psychotic disorder also related to impaired competence to make treatment decisions. The issue of competence to make treatment decisions may have utility for evaluations and restoration of fitness to stand trial and tending to it may help to alleviate systems burdens.
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