Impaired insight in patients with newly diagnosed nonaffective psychotic disorders with and without deficit features.
Patients with schizophrenia who have primary, enduring negative symptoms, or the deficit syndrome, have poorer psychosocial functioning but lesser clinical distress compared with nondeficit patients. Poor awareness of impairment in patients with deficit schizophrenia may contribute to this seeming contradiction. We hypothesized that poor insight would be present early in the course of illness in deficit patients, and that those with deficit features would have greater impairment in insight than those without deficit features. One-hundred one first-episode patients with nonaffective psychotic disorders were categorized into deficit (n=31) and nondeficit (n=70) groups. The deficit patients had significantly poorer insight than nondeficit patients when rated using a self-report questionnaire, and nearly significantly poorer insight rated by clinical researchers. Further, this effect remained for self-rated insight and reached statistical significance for researcher-rated insight after controlling for positive, negative, and general psychopathology symptoms. These results suggest that the treatment of deficit patients may be particularly complicated by poor insight.
Trotman
Hanan D
HD
Department of Psychiatry and Health Behavior, Medical College of Georgia, School of Medicine, Augusta, GA, United States.
Kirkpatrick
Brian
B
Compton
Michael T
MT
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000150:complications* / Q000175:diagnosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis*; D019966:Substance-Related Disorders / Q000503:physiopathology; D055815:Young Adult
J Int Neuropsychol Soc. 2009 May;15(3):471-5
19402933
Soc Psychiatry Psychiatr Epidemiol. 2008 Dec;43(12):975-82
18604616
Acta Psychiatr Scand. 1994 Jan;89(1):62-7
7908156
Eur Arch Psychiatry Clin Neurosci. 2006 Sep;256(6):356-63
16902732
Schizophr Bull. 2007 Sep;33(5):1201-12
17159230
Schizophr Bull. 2000;26(1):233-42
10755684
Schizophr Bull. 2010 Jul;36(4):788-99
19095758
Am J Psychiatry. 1988 May;145(5):578-83
3358462
Psychiatry Res. 1989 Nov;30(2):119-23
2616682
Schizophr Res. 1997 Oct 17;27(1):37-44
9373893
J Nerv Ment Dis. 2005 Dec;193(12):803-8
16319702
Schizophr Res. 1996 Nov 15;22(2):119-26
8958595
Psychiatr Serv. 2009 Nov;60(11):1489-94
19880467
Psychopharmacol Bull. 1988;24(4):689-92
3249771
Schizophr Res. 2007 Jan;89(1-3):22-34
17097853
J Clin Psychiatry. 2010 Oct;71(10):1279-85
20492836
Am J Psychiatry. 2000 Apr;157(4):560-5
10739414
Acta Psychiatr Scand. 2007 Feb;115(2):93-100
17244172
Eur Psychiatry. 2009 May;24(4):239-43
19070996
Psychol Med. 2009 Sep;39(9):1433-45
19091160
Am J Psychiatry. 1994 Oct;151(10):1417-22
8092335
J Nerv Ment Dis. 1999 Feb;187(2):102-8
10067950
Psychiatry Res. 1993 Apr;47(1):47-56
8516416
Schizophr Res. 2003 Sep 1;63(1-2):103-9
12892864
Schizophr Res. 1996 May;20(1-2):79-90
8794496
Eur Arch Psychiatry Clin Neurosci. 2003 Oct;253(5):221-7
14504990
J Nerv Ment Dis. 2001 Jan;189(1):24-30
11206661
Am J Psychiatry. 1994 Mar;151(3):351-6
7906493
J Nerv Ment Dis. 2007 Dec;195(12):976-82
18091190
Am J Psychiatry. 1999 Jul;156(7):1097-9
10401460
J Nerv Ment Dis. 1994 Aug;182(8):452-5
8040655
Schizophr Bull. 1987;13(2):261-76
3616518
Am J Psychiatry. 1990 Mar;147(3):290-4
2309943
Arch Gen Psychiatry. 1994 Oct;51(10):804-11
7944870
J Psychiatr Pract. 2004 Jan;10(1):5-16
15334983
Br J Psychiatry Suppl. 1993 Dec;(22):39-44
8110442
Arch Gen Psychiatry. 2001 Feb;58(2):165-71
11177118
Schizophr Res. 1995 Dec;18(1):21-8
8929757
Schizophr Res. 2006 Sep;86(1-3):54-70
16837168
Schizophr Res. 1996 May;20(1-2):69-77
8794495
Curr Opin Psychiatry. 2006 Nov;19(6):637-41
17012945
Schizophr Res. 2003 May 1;61(1):75-88
12648738
Am J Psychiatry. 1993 Jun;150(6):873-9
8494061
Schizophr Res. 1999 Feb 15;35(3):247-53
10093870
Schizophr Res. 2009 Dec;115(2-3):338-45
19833482
J Nerv Ment Dis. 1998 Jul;186(7):432-6
9680045
Schizophr Res. 1998 Sep 7;33(1-2):63-7
9783345
Arch Gen Psychiatry. 1994 Oct;51(10):826-36
7944872
J Clin Psychiatry. 2011 Feb;72(2):225-32
21382306
Schizophr Res. 2004 Jul 1;69(1):7-14
15145465