Longitudinal changes of insight in first episode psychosis and its relation to clinical symptoms, treatment adherence and global functioning: one-year follow-up from the Eiffel study.
OBJECTIVE
The Eiffel study is a longitudinal, naturalistic study of patients with first episode psychosis (FEP) designed to evaluate the predictive value of defective insight on treatment adherence and global functioning.


METHODS
Five hundred seventy-seven patients with FEP were assessed at baseline and at a 1-year follow-up. They were compared in terms of sociodemographic factors, psychopathology, insight, treatment adherence and functional outcome. Longitudinal functionality was prospectively assessed with the clinical global impression (CGI) and global assessment of functioning (GAF) rating scales.


RESULTS
At baseline, up to 50% of our sample presented with a lack of insight. Most clinical symptoms, including insight, improved over the follow-up period. Insight, education and social withdrawal significantly predicted CGI and GAF at follow-up. Insight and level of education were predictive of treatment adherence.


CONCLUSIONS
Insight significantly predicted the general clinical course, treatment adherence and functional outcome in our FEP sample after 1 year. Only education additionally accounted for the longitudinal course. Since our results suggest that better insight improves treatment adherence and consequently clinical course and functional outcome, insight could be a specific target of treatment in early intervention programs.
Segarra
R
R
First Episode Psychosis Unit, Psychiatry Department, Cruces Hospital, Plaza de Cruces, s/n. 48903 Baracaldo, Spain. rafael.segarraechevarria@osakidetza.net
Ojeda
N
N
Peña
J
J
García
J
J
Rodriguez-Morales
A
A
Ruiz
I
I
Hidalgo
R
R
Burón
J A
JA
Eguiluz
J I I
JI
Gutiérrez
M
M
D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D032882:Comprehension; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology*; D012559:Schizophrenia / Q000188:drug therapy; D012565:Schizophrenic Psychology; D016903:Drug Monitoring
D014150:Antipsychotic Agents