title: The relationship between insight and clinical features in bipolar disorder.
abstract: OBJECTIVE
  The aim of this study is to examine the relationship between insight dimensions and clinical features in bipolar disorder.
  
  
  METHODS
  One hundred and four inpatients with bipolar disorder( manic or mixed episodes) diagnosed according to DSM-IV criteria participated in the study. Patients were evaluated both during an acute episode and in remission, prior their discharge from the hospital by the Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS), Positive and Negative Syndrome Scale (PANSS), The Scale of Unawareness of Mental Disorders (SUMD), and a questionnaire regarding demographic and clinical characteristics.
  
  
  RESULTS
  In remission, 57 patients (54.8%) had insight of their illness while 14 (13.5%)did not have insight. Besides  %6.7 of patients did not have the Insight into the effects of medication. We also found that 27.9% of patients were unaware of the social consequences of their illness. Patients with psychotic symptoms had a significantly low level of awareness to the effects of their medication as well as the severeness of their manic episode. We found an unawareness of delusion in these patients. In terms of all SUMD items, female patients had significantly poorer insight compared to men. No correlation was found between the number of hospitalizations, the number of episodes or the first episode type and insight dimensions.
  
  
  CONCLUSIONS
  Lack of insight in bipolar disorder is not rare. The assesment of insight addresses different components of the illness and the treatment awareness. The severity of illness,  aggressive impulse control difficulties, psychotic symptoms especially the presence of delusions, female sex may be important predictors of impaired insight.
authors.affiliation: Bakırköy Prof. Mazhar Osman Psychiatric and Neurological Illnesss Training and Investigation Hospital, 9th Psychiatry Clinic, İstanbul. oyaguclug@yahoo.com
authors.forename: Oya
authors.initials: O
authors.lastname: Güçlü
authors.forename: Orhan
authors.initials: O
authors.lastname: Karaca
authors.forename: Bülent
authors.initials: B
authors.lastname: Yıldırım
authors.forename: Mehmet Mustafa
authors.initials: MM
authors.lastname: Ozköse
authors.forename: Murat
authors.initials: M
authors.lastname: Erkıran
mesh_terms: D001364:Awareness; D001714:Bipolar Disorder / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires