title: Mechanisms of insight in schizophrenia and impact of cognitive remediation therapy.
abstract: The origins of poor insight in schizophrenia are still unclear. We contrasted the changes in clinical insight, basic cognitive processes, autobiographical memory and metacognition in 63 outpatients with schizophrenia pseudo-randomly assigned to one of three cognitive remediation groups: one targeting basic cognitive processes (RECOS), a second autobiographical memory (REMAu), and a third metacognitive deficits (MBCT). Three dimensions of insight (awareness of: mental illness, benefit of treatment, psychosocial consequences) improved after treatment, regardless of the group. In addition, the REMAu and MBCT showed an improvement on other dimensions of insight (symptomatic awareness and symptomatic attribution, respectively). Poor insight and its improvement after treatment were best predicted by a combination of basic cognitive, autobiographical and metacognitive measures. This study supports a multidimensional conception of insight and recommends the combination of remediation therapies to improve clinical insight in schizophrenia.
authors.affiliation: Laboratoire Mémoire et Cognition, Institut de Psychologie, Université Paris Descartes, France.
authors.forename: Maria
authors.initials: M
authors.lastname: Lalova
authors.forename: Franck
authors.initials: F
authors.lastname: Baylé
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Grillon
authors.forename: Laëtitia
authors.initials: L
authors.lastname: Houet
authors.forename: Elodie
authors.initials: E
authors.lastname: Moreau
authors.forename: Francis
authors.initials: F
authors.lastname: Rouam
authors.forename: Pascal
authors.initials: P
authors.lastname: Cacot
authors.forename: Pascale
authors.initials: P
authors.lastname: Piolino
mesh_terms: D000704:Analysis of Variance; D001364:Awareness; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D055815:Young Adult