Changes in insight among patients with bipolar I disorder: a 2-year prospective study.
OBJECTIVE
The aim of this 2-year prospective study was to examine changes in insight among bipolar patients with different clinical courses.


METHODS
A cohort of 65 patients with bipolar I disorder in remission was recruited for this study. They received six follow-up assessments over a 2-year period. The Schedule of Assessment of Insight-Expanded version (SAI-E) was used to determine their levels of insight, while the Young Mania Rating Scale (YMRS) and the Hamilton Rating Scale for Depression (HAM-D) were used to determine affective symptoms. Types of changes in insight among bipolar patients were analyzed according to the different clinical courses during the 2-year follow-up period.


RESULTS
Insight in consistently stable patients was steady during the 2-year period. Insight decreased during the manic period in patients with only a single manic episode as well as in those with repeated manic episodes. However, insight returned to the pre-episode level for patients with only a single manic episode, but did not for most of the patients with repeated episodes. No changes in insight were observed during depressive episodes for either patients with a single or those with repeated depressive episodes.


CONCLUSIONS
The types of insight changes among bipolar patients during the 2-year period were various and depended on the different clinical courses. Frequent mood disturbance episodes may cause patient insight to deteriorate.
Yen
Cheng-Fang
CF
Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chen
Cheng-Sheng
CS
Ko
Chih-Hung
CH
Yen
Ju-Yu
JY
Huang
Chi-Feng
CF
D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires