title: Manic and depressive symptoms and insight in first episode psychosis.
abstract: Insight impairment is common early in the course of psychosis. Most studies have focused on the relationship between insight and depression, although manic symptoms are also frequent in psychoses. The main aim of this study was to examine the relationship between insight dimensions and manic and depressive symptoms in first-episode psychosis. A group of inpatients in their first psychotic episodes (n=124) were evaluated using the Scale to Assess Unawareness of Mental Disorder, Young Mania Rating Scale and Hamilton Depression Rating Scale. To study the effect of clinical, manic and depressive symptoms on insight, awareness of mental disorder, awareness of the achieved effects of medication, and awareness of the social consequences of having a mental disorder were modelled using ordinal logistic regression techniques. Results showed that greater awareness of mental disorder was significantly related to higher age at first episode together with higher scores for negative and depressive symptoms. The opposite was found to be true in presentations with a higher severity of disease and manic symptoms. The model fitting unawareness of the achieved effects of medication identified the same significant variables, except in the case of negative symptoms. Finally, the model assessing the social consequences of having a mental disorder showed unawareness to be greater when manic symptoms and disease severity were high.
authors.affiliation: Santiago Apóstol Hospital, Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Centro de Investigación Biomédica en Red de Salud Mental (CIBER-sam), EHU/UPV, Vitoria, Spain.
authors.forename: Saioa
authors.initials: S
authors.lastname: Aspiazu
authors.forename: Fernando
authors.initials: F
authors.lastname: Mosquera
authors.forename: Berta
authors.initials: B
authors.lastname: Ibañez
authors.forename: Patricia
authors.initials: P
authors.lastname: Vega
authors.forename: Sara
authors.initials: S
authors.lastname: Barbeito
authors.forename: Puri
authors.initials: P
authors.lastname: López
authors.forename: Sonia
authors.initials: S
authors.lastname: Ruiz de Azúa
authors.forename: Amaia
authors.initials: A
authors.lastname: Ugarte
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.forename: Ana
authors.initials: A
authors.lastname: González-Pinto
mesh_terms: D000328:Adult; D001364:Awareness; D001714:Bipolar Disorder / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology*; D012044:Regression Analysis; D012189:Retrospective Studies; D013030:Spain; D055815:Young Adult