Clinical and neuropsychological correlates of insight in schizophrenia and bipolar I disorder: does diagnosis matter?

2.50
Hdl Handle:
http://hdl.handle.net/2336/21194
Title:
Clinical and neuropsychological correlates of insight in schizophrenia and bipolar I disorder: does diagnosis matter?
Authors:
Varga, Monica; Magnusson, Andres; Flekkøy, Kjell; David, Anthony S; Opjordsmoen, Stein
Citation:
Compr Psychiatry 2007, 48(6):583-91
Issue Date:
1-Nov-2007
Abstract:
BACKGROUND: Lack of insight is a well-recognized feature of schizophrenia and is associated with symptom severity and cognitive impairments. However, the diagnostic specificity of insight variables and their correlates is not known. To assess this specificity, we compared awareness of illness and neuropsychological function between patients with chronic schizophrenia and bipolar I disorder. METHOD: We assessed insight, level of psychopathology, and cognitive performance on a neuropsychological test battery in 37 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar I disorder, 32 patients with schizophrenia, and 31 healthy subjects for comparison. RESULTS: There was no significant difference between the 2 diagnostic groups on general illness awareness. However, patients with bipolar disorder had better awareness of their symptoms and their pathologic nature compared to patients with schizophrenia. Similar patterns of association emerged between insight and clinical variables. General unawareness was associated with clinical severity, especially of the affective type, and working memory deficits (Wechsler Adult Intelligence Scale digit span) in both diagnostic groups. The contribution of other cognitive deficits to insight differed across the groups. Misattribution differed from the other aspects of insight in its relative independence of clinical and neurocognitive correlates. Both patient groups were neurocognitively impaired, with the schizophrenia group performing significantly worse on conceptual ability, verbal learning, visuospatial processing, and motor speed. CONCLUSIONS: The results suggest that differences in general insight in major mental disorders may be explained by symptom severity and working memory function rather than the specific diagnosis. Subcomponents of insight are influenced by different factors emphasizing the need to consider insight as multidimensional.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.sciencedirect.com/science/article/B6WCV-4PG8HF4-2/2/c21234c5ff587d9a7216c8dea13dbb8a

Full metadata record

DC FieldValue Language
dc.contributor.authorVarga, Monica-
dc.contributor.authorMagnusson, Andres-
dc.contributor.authorFlekkøy, Kjell-
dc.contributor.authorDavid, Anthony S-
dc.contributor.authorOpjordsmoen, Stein-
dc.date.accessioned2008-03-19T15:43:29Z-
dc.date.available2008-03-19T15:43:29Z-
dc.date.issued2007-11-01-
dc.date.submitted2008-03-19-
dc.identifier.citationCompr Psychiatry 2007, 48(6):583-91en
dc.identifier.issn0010-440X-
dc.identifier.pmid17954145-
dc.identifier.doi10.1016/j.comppsych.2007.06.003-
dc.identifier.urihttp://hdl.handle.net/2336/21194-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Lack of insight is a well-recognized feature of schizophrenia and is associated with symptom severity and cognitive impairments. However, the diagnostic specificity of insight variables and their correlates is not known. To assess this specificity, we compared awareness of illness and neuropsychological function between patients with chronic schizophrenia and bipolar I disorder. METHOD: We assessed insight, level of psychopathology, and cognitive performance on a neuropsychological test battery in 37 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar I disorder, 32 patients with schizophrenia, and 31 healthy subjects for comparison. RESULTS: There was no significant difference between the 2 diagnostic groups on general illness awareness. However, patients with bipolar disorder had better awareness of their symptoms and their pathologic nature compared to patients with schizophrenia. Similar patterns of association emerged between insight and clinical variables. General unawareness was associated with clinical severity, especially of the affective type, and working memory deficits (Wechsler Adult Intelligence Scale digit span) in both diagnostic groups. The contribution of other cognitive deficits to insight differed across the groups. Misattribution differed from the other aspects of insight in its relative independence of clinical and neurocognitive correlates. Both patient groups were neurocognitively impaired, with the schizophrenia group performing significantly worse on conceptual ability, verbal learning, visuospatial processing, and motor speed. CONCLUSIONS: The results suggest that differences in general insight in major mental disorders may be explained by symptom severity and working memory function rather than the specific diagnosis. Subcomponents of insight are influenced by different factors emphasizing the need to consider insight as multidimensional.en
dc.language.isoenen
dc.publisherW.B. Saundersen
dc.relation.urlhttp://www.sciencedirect.com/science/article/B6WCV-4PG8HF4-2/2/c21234c5ff587d9a7216c8dea13dbb8aen
dc.subject.meshAdulten
dc.subject.meshAwarenessen
dc.subject.meshBipolar Disorderen
dc.subject.meshCase-Control Studiesen
dc.subject.meshCognition Disordersen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMemory Disordersen
dc.subject.meshNeuropsychological Testsen
dc.subject.meshPsychiatric Status Rating Scalesen
dc.subject.meshRegression Analysisen
dc.subject.meshSchizophreniaen
dc.subject.meshSchizophrenic Psychologyen
dc.subject.meshSeverity of Illness Indexen
dc.titleClinical and neuropsychological correlates of insight in schizophrenia and bipolar I disorder: does diagnosis matter?en
dc.typeArticleen
dc.contributor.departmentDepartment of Acute Psychiatric Emergency Ward, Aker University Hospital, N-0514 Oslo, Norway. monvarga@online.noen
dc.identifier.journalComprehensive psychiatryen

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