title: Insight in bipolar disorder.
abstract: Although there has been interest in insight in bipolar disorder, research has not been as developed as in schizophrenia. The Medline, Embase, and PsychInfo data bases were searched. The key words used in the search were "bipolar", "mania", "manic", "awareness", and "insight". Books, editorials, letters, and reports on pediatric subjects were excluded. Abstracts or full texts were screened for relevance. Better insight is associated with better adherence to treatment and better outcomes. Impairments of executive functions and memory, as well as higher severity of psychotic symptoms, are associated with impairments of insight. Insight is more impaired during an illness episode than during remission, in mixed than in pure manic episodes, in bipolar II than in bipolar I patients, in pure mania than in bipolar or unipolar depression. Psychosocial treatments improve insight and outcomes. There is a need for integration of quantitative assessment methods and their introduction into research and clinical practice.
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacký University Olomouc, I.P.Pavlova 6, 77520, Olomouc, Czech Republic. klaralat@centrum.cz
authors.forename: Klára
authors.initials: K
authors.lastname: Látalová
mesh_terms: D018692:Antimanic Agents / Q000627:therapeutic use; D001294:Attitude to Health; D001364:Awareness; D001714:Bipolar Disorder / Q000188:drug therapy / Q000473:pathology / Q000523:psychology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D003430:Cross-Sectional Studies; D016206:Databases, Bibliographic; D003717:Denial, Psychological; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology; D011859:Radiography; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index
chemical_list: D018692:Antimanic Agents
references.citation: Bipolar Disord. 2004 Aug;6(4):294-8
references.pmid: 15225146
references.citation: J Psychiatr Res. 2004 Mar-Apr;38(2):185-91
references.pmid: 14757333
references.citation: Br J Psychiatry. 1990 Jun;156:798-808
references.pmid: 2207510
references.citation: BMJ. 2010 Apr 27;340:c1900
references.pmid: 20423957
references.citation: Science. 1973 Dec 21;182(4118):1275-8
references.pmid: 4752222
references.citation: J Nerv Ment Dis. 2002 Oct;190(10):713-5
references.pmid: 12409868
references.citation: Compr Psychiatry. 2000 May-Jun;41(3):167-71
references.pmid: 10834624
references.citation: Acta Psychiatr Scand. 1994 Jul;90(1):46-9
references.pmid: 7976449
references.citation: Psychiatry Res. 2000 Nov 20;100(1):49-58
references.pmid: 11090725
references.citation: J Affect Disord. 1998 Apr;49(1):55-8
references.pmid: 9574860
references.citation: Compr Psychiatry. 2007 Nov-Dec;48(6):583-91
references.pmid: 17954145
references.citation: J Nerv Ment Dis. 1995 Dec;183(12):743-51
references.pmid: 8522935
references.citation: Psychol Med. 1998 May;28(3):551-8
references.pmid: 9626712
references.citation: J Affect Disord. 2009 Jul;116(1-2):56-63
references.pmid: 19062101
references.citation: J Nerv Ment Dis. 1989 Jan;177(1):48-51
references.pmid: 2535871
references.citation: Acta Psychiatr Scand. 1998 Apr;97(4):297-301
references.pmid: 9570491
references.citation: Psychiatr Serv. 2002 Jan;53(1):96-8
references.pmid: 11773658
references.citation: Bipolar Disord. 2002 Dec;4(6):386-92
references.pmid: 12519098
references.citation: Schizophr Res. 2000 Oct 27;45(3):203-11
references.pmid: 11042438
references.citation: Psychol Med. 1998 Mar;28(2):437-46
references.pmid: 9572100
references.citation: Acta Psychiatr Scand. 1992 Aug;86(2):159-64
references.pmid: 1529740
references.citation: J Affect Disord. 2009 Jul;116(1-2):51-5
references.pmid: 19101038
references.citation: Bipolar Disord. 2002 Oct;4(5):315-22
references.pmid: 12479664
references.citation: J Clin Psychiatry. 2009;70 Suppl 4:1-46; quiz 47-8
references.pmid: 19686636
references.citation: J Nerv Ment Dis. 1995 Feb;183(2):103-6
references.pmid: 7844571
references.citation: Schizophr Bull. 2009 Mar;35(2):336-46
references.pmid: 18586692
references.citation: Compr Psychiatry. 2008 Jul-Aug;49(4):335-9
references.pmid: 18555052
references.citation: Hum Psychopharmacol. 2010 Jan;25(1):1-16
references.pmid: 20041478
references.citation: Schizophr Res. 1996 Dec 15;22(3):257-63
references.pmid: 9000323
references.citation: J Affect Disord. 2008 May;108(1-2):121-7
references.pmid: 17997489
references.citation: J Nerv Ment Dis. 1998 Jan;186(1):44-50
references.pmid: 9457146
references.citation: Lancet. 2008 Mar 29;371(9618):1085-97
references.pmid: 18374841
references.citation: Arch Gen Psychiatry. 2003 Apr;60(4):402-7
references.pmid: 12695318
references.citation: Harv Rev Psychiatry. 1994 May-Jun;2(1):22-33
references.pmid: 9384876
references.citation: J Nerv Ment Dis. 2001 Jun;189(6):398-9
references.pmid: 11434641
references.citation: Eur Psychiatry. 2004 Feb;19(1):8-14
references.pmid: 14969775
references.citation: Bipolar Disord. 2009 Mar;11(2):190-7
references.pmid: 19267701
references.citation: J Affect Disord. 2008 Sep;110(1-2):75-83
references.pmid: 18272231
references.citation: Schizophr Bull. 2011 Jan;37(1):38-51
references.pmid: 20884756
references.citation: Br J Psychiatry. 1978 Nov;133:429-35
references.pmid: 728692
references.citation: Br J Psychiatry Suppl. 1989 Nov;(7):59-67
references.pmid: 2619982
references.citation: J Nerv Ment Dis. 1996 Nov;184(11):653-9
references.pmid: 8955677
references.citation: Psychiatry Clin Neurosci. 2005 Aug;59(4):403-9
references.pmid: 16048445
references.citation: Psychiatry Res. 1999 Jun 30;86(3):239-49
references.pmid: 10482343
references.citation: Schizophr Bull. 1989;15(2):245-52
references.pmid: 2749187
references.citation: Acta Psychiatr Scand. 1994 Jan;89(1):62-7
references.pmid: 7908156
references.citation: J Nerv Ment Dis. 1989 Jan;177(1):43-7
references.pmid: 2562850
references.citation: J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
references.pmid: 14399272
references.citation: J Clin Psychiatry. 2002 May;63(5):384-90
references.pmid: 12019661
references.citation: Arch Gen Psychiatry. 1976 Jun;33(6):766-71
references.pmid: 938196
references.citation: Compr Psychiatry. 1995 Sep-Oct;36(5):367-76
references.pmid: 7497711
references.citation: J Nerv Ment Dis. 2002 Dec;190(12):847-9
references.pmid: 12486373
references.citation: Br J Psychiatry. 2006 Sep;189:204-12
references.pmid: 16946354
references.citation: Schizophr Res. 2000 Sep 29;45(1-2):29-36
references.pmid: 10978870
references.citation: Bipolar Disord. 2003 Feb;5(1):14-21
references.pmid: 12656933
references.citation: Psychiatry Res. 1996 Nov 15;65(2):113-20
references.pmid: 9122285
references.citation: Schizophr Res. 2004 Jun 1;68(2-3):319-29
references.pmid: 15099613
references.citation: J Nerv Ment Dis. 2008 Jan;196(1):16-21
references.pmid: 18195637
references.citation: J Clin Psychol. 2008 Apr;64(4):466-81
references.pmid: 18357575
references.citation: Encephale. 2008 Dec;34(6):597-605
references.pmid: 19081457
references.citation: J Nerv Ment Dis. 2008 Apr;196(4):333-5
references.pmid: 18414129
references.citation: Am J Psychiatry. 1993 Jun;150(6):873-9
references.pmid: 8494061
references.citation: Am J Psychiatry. 2005 Nov;162(11):2195; author reply 2195
references.pmid: 16263874
references.citation: Psychiatry Res. 2003 Jul 15;119(1-2):81-8
references.pmid: 12860362
references.citation: J Nerv Ment Dis. 1995 Dec;183(12):752-5
references.pmid: 8522936
references.citation: Bipolar Disord. 2007 Nov;9(7):737-42
references.pmid: 17988364
references.citation: Compr Psychiatry. 1997 Sep-Oct;38(5):283-8
references.pmid: 9298321
references.citation: Am J Psychiatry. 1999 Jul;156(7):1094-6
references.pmid: 10401459
references.citation: Arch Gen Psychiatry. 1994 Oct;51(10):826-36
references.pmid: 7944872
references.citation: J Affect Disord. 2006 Mar;91(1):1-9
references.pmid: 16442637
references.citation: Schizophr Res. 2003 Mar 1;60(1):71-80
references.pmid: 12505140
references.citation: Bipolar Disord. 2003 Apr;5(2):115-22
references.pmid: 12680901
references.citation: Int J Clin Pract. 2009 Jun;63(6):889-99
references.pmid: 19490199
references.citation: J Nerv Ment Dis. 2008 Jun;196(6):462-7
references.pmid: 18552623
references.citation: BMJ. 1996 Feb 10;312(7027):345-9
references.pmid: 8611831
references.citation: Bipolar Disord. 2010 Jun;12(4):364-75
references.pmid: 20636633
references.citation: Am J Psychiatry. 2001 Jan;158(1):122-5
references.pmid: 11136644