Early insight predicts depression and attempted suicide after 4 years in first-episode schizophrenia and schizophreniform disorder.
OBJECTIVE
To map the development of insight in the 4 years after presentation with first-episode schizophrenia and schizophreniform disorder and to determine the effects of evolving insight on depression and the likelihood of attempted suicide.


METHODS
We assessed 101 individuals at presentation, 6 months and 4 years. We measured insight, including recognition of mental illness, recognition of need for treatment and ability to relabel psychotic symptoms. We measured depression and recorded all suicide attempts.


RESULTS
Insight improved with time. Recognition of mental illness at 6 months predicted depression and attempted suicide at 4 years.


CONCLUSIONS
Six months after presentation, the greater the acknowledgement by people that they had a mental illness, the more depressed they were at 4 years and the greater the likelihood that they would attempt suicide by 4 years. This may have implications for disclosure of diagnosis.
Crumlish
N
N
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Cluain Mhuire Family Centre, Blackrock, Ireland.
Whitty
P
P
Kamali
M
M
Clarke
M
M
Browne
S
S
McTigue
O
O
Lane
A
A
Kinsella
A
A
Larkin
C
C
O'Callaghan
E
E
D000328:Adult; D003863:Depression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D011618:Psychotic Disorders / Q000523:psychology*; D012565:Schizophrenic Psychology; D012649:Self Concept; D013406:Suicide, Attempted