Psychological predictors of insight and compliance in psychotic patients.
BACKGROUND
A possible neuropsychological basis for poor insight in psychosis has been proposed. Consistent supporting evidence for this is lacking.


METHODS
Seventy-four consecutive acutely psychotic in-patients who were recruited for a randomised controlled trial of compliance therapy were given a battery of neuropsychological tests, along with a comprehensive clinical assessment, before and after the intervention.


RESULTS
Performance on neuropsychological tests improved during the patients' admission and treatment in hospital, as did symptoms and levels of insight. Cognitive function showed no relationship to insight and compliance initially, and very little after the intervention. Factors related to insight and compliance prior to discharge included: diagnosis, attitudes to medication, side-effects, being a detained patient, and whether or not compliance therapy was given.


CONCLUSIONS
Clinical variables and attitudes to treatment appear to be more relevant to compliance and the development of insight in acute psychosis than neuropsychological impairment.
Department of Psychological Medicine, King's College School of Medicine and Dentistry, London.
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Kemp
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David
D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010343:Patient Admission; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D011446:Prospective Studies; D011594:Psychometrics; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D012559:Schizophrenia / Q000628:therapy; D012565:Schizophrenic Psychology; D016896:Treatment Outcome