Insight in individuals with an At Risk Mental State.
OBJECTIVE
On average, people with an At Risk Mental State (ARMS) for psychosis are more willing to seek and accept clinical help than patients with psychotic disorders, suggesting that insight in this group is relatively less impaired. We compared the level and quality of insight in the ARMS and in first episode psychosis.


METHODS
Insight about illness was assessed in subjects with an ARMS and in patients with first episode psychosis (FEP) who were and were not help-seeking, using the Schedule for Assessment of Insight (SAI-E).


RESULTS
Insight was impaired in ARMS subjects, but there was considerable variability in the insight displayed between subjects. Compared to FEP subjects, ARMS subjects showed greater insight, particularly with respect to Symptom Relabelling. ARMS subjects were more likely to interpret anomalous experiences as symptoms of illness, and to perceive themselves as needing treatment.


CONCLUSIONS
Insight in people at high risk for psychosis is impaired, despite the fact that they are help-seeking. Insight varies between subjects, highlighting the need to comprehensively assess all aspects of insight in those with an ARMS. ARMS subjects are impaired in their ability to appraise anomalous experiences as symptoms of illness, but much less impaired than FEP subjects. This is consistent with cognitive models that propose that the way symptoms are appraised determines whether the individual develops a psychotic illness.
Lappin
Julia M
JM
King's College London Institute of Psychiatry, PO63, Division of Psychological Medicine, London SE5 8AF, UK. j.lappin@iop.kcl.ac.uk
Morgan
Kevin D
KD
Valmaggia
Lucia R
LR
Broome
Matthew R
MR
Woolley
James B
JB
Johns
Louise C
LC
Tabraham
Paul
P
Bramon
Elvira
E
McGuire
Philip K
PK
D000293:Adolescent; D000328:Adult; D001364:Awareness; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D012016:Reference Values; D015203:Reproducibility of Results; D018570:Risk Assessment; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000235:genetics / Q000523:psychology