Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study.
BACKGROUND
Beck Cognitive Insight Scale (BCIS) has been designed for assessment of self-reflection on patients' anomalous experiences and interpretations of own beliefs. The scale has been developed and validated for patients with schizophrenia. We wanted to study the utility of the scale for patients with bipolar disorder. The relationship between the BCIS as a measure of cognitive insight and established methods for assessment of insight of illness was explored in both diagnostic groups.


METHODS
The BCIS self-report inventory was administered to patients with schizophrenia (n = 143), bipolar disorder (n = 92) and controls (n = 64). The 15 items of the inventory form two subscales, self-reflectiveness and self-certainty.


RESULTS
The internal consistency of the subscales was good for the patient groups and the controls. The mean subscale scores were not significantly different for the three groups. Four items in subscale self-reflectiveness referring to psychotic experiences gave, however, different results in the control subjects. Self-certainty and scores on insight item PANSS correlated significantly in the schizophrenia, but not in the bipolar group.


CONCLUSIONS
BCIS with its two subscales seems applicable for patients with bipolar disorder as well as for patients with schizophrenia. The self-report inventory can also be applied to control subjects if the items referring to psychotic experiences are omitted. In schizophrenia high scores on self-certainty is possibly associated with poor insight of illness. For the bipolar group the subscales are largely independent of traditional insight measures.
Engh
John A
JA
Division of Psychiatry, Ulleval University Hospital, Oslo, Norway. john.engh@medisin.uio.no
Friis
Svein
S
Birkenaes
Astrid B
AB
Jónsdóttir
Halldóra
H
Ringen
Petter A
PA
Ruud
Torleif
T
Sundet
Kjetil S
KS
Opjordsmoen
Stein
S
Andreassen
Ole A
OA
D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000453:epidemiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires