Insight dimensions and cognitive function in psychosis: a longitudinal study.
BACKGROUND
It has been reported that lack of insight is significantly associated with cognitive disturbance in schizophrenia. This study examines the longitudinal relationships between insight dimensions and cognitive performance in psychosis.


METHODS
Participants were 75 consecutively admitted inpatients with schizophrenia, affective disorder with psychotic symptoms or schizoaffective disorder. Assessments were conducted at two time points during the study: at the time of hospital discharge after an acute psychotic episode and at a follow-up time that occurred more than 6 months after discharge. A multidimensional approach of insight was chosen and three instruments for its assessment were used: the Scale to Assess Unawareness of Mental Disorder (SUMD), three items concerning insight on the Assessment and Documentation in Psychopathology (AMDP) system and the Insight and Treatment Attitudes Questionnaire. The neuropsychological battery included a wide range of tests that assessed global cognitive function, attention, memory, and executive functions.


RESULTS
After conducting adequate statistical correction to avoid Type I bias, insight dimensions and cognitive performance were not found to be significantly associated at cross-sectional and longitudinal assessments. In addition, baseline cognitive performance did not explain changes in insight dimensions at follow-up. Similar results were found in the subset of patients with schizophrenia (n = 37). The possibility of a Type II error might have increased due to sample attrition at follow-up.


CONCLUSIONS
These results suggest that lack of insight dimensions and cognitive functioning may be unrelated phenomena in psychosis.
Cuesta
Manuel J
MJ
Psychiatric Unit of Virgen del Camino Hospital, E-31008 Pamplona, Spain. mcuestaz@cfnavarra.es
Peralta
Victor
V
Zarzuela
Amalia
A
Zandio
Maria
M
D000328:Adult; D001294:Attitude to Health; D001364:Awareness; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008960:Models, Psychological; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010349:Patient Compliance; D010351:Patient Discharge; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology