title: Trait and state attributes of insight in first episodes of early-onset schizophrenia and other psychoses: a 2-year longitudinal study.
abstract: BACKGROUND
  Increasing evidence supports the important role of illness state and individual characteristics in insight.
  
  
  METHODS
  Insight, as measured with the Scale to Assess Unawareness of Mental Disorder, over the first 2 years of early-onset first-episode psychosis and its correlations with clinical, socio-demographic, cognitive, and structural brain variables are studied.
  
  
  RESULTS
  (1) insight at 2 years is poorer in schizophrenia spectrum disorders (SSDs) than in subjects with other psychoses; (2) the more severe the psychosis, the worse the insight. In SSD, depressive symptoms, poorer baseline executive functioning, lower IQ, longer duration of untreated psychosis (DUP), and poorer premorbid infancy adjustment are associated with poorer insight; frontal and parietal gray matter (GM) reductions at baseline correlate with worse insight into having psychotic symptoms at 2 years; (3) insight into having a mental disorder (Scale to Assess Unawareness of Mental Disorder [SUMD]1) at 1 year, DUP, and baseline IQ are the most consistent variables explaining different aspects of insight at 2 years in SSD patients. IQ and SUMD1 at 1 year, together with left frontal and parietal GM volumes, explain 80% of the variance of insight into having specific psychotic symptoms in SSD patients (adjusted R(2) = 0.795, F = 15.576, P < .001).
  
  
  CONCLUSIONS
  Insight is a complex phenomenon that depends both on severity of psychopathology and also on disease and subject characteristics, such as past adjustment, IQ, DUP, cognitive functioning, frontal and parietal GM volumes, and age, gender, and ethnicity.
authors.affiliation: Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Ibiza 43, Madrid 28009, Spain. parellada@hggm.es
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
authors.forename: Leticia
authors.initials: L
authors.lastname: Boada
authors.forename: David
authors.initials: D
authors.lastname: Fraguas
authors.forename: Santiago
authors.initials: S
authors.lastname: Reig
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
authors.forename: Dolores
authors.initials: D
authors.lastname: Moreno
authors.forename: Ana
authors.initials: A
authors.lastname: Gonzalez-Pinto
authors.forename: Soraya
authors.initials: S
authors.lastname: Otero
authors.forename: Marta
authors.initials: M
authors.lastname: Rapado-Castro
authors.forename: Montserrat
authors.initials: M
authors.lastname: Graell
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001364:Awareness; D001921:Brain / Q000473:pathology*; D002648:Child; D003071:Cognition; D003863:Depression; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D010296:Parietal Lobe / Q000473:pathology; D011618:Psychotic Disorders / Q000473:pathology / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis / Q000473:pathology*; D012565:Schizophrenic Psychology; D012737:Sex Factors; D012917:Social Adjustment