title: Insight change in psychosis: relationship with neurocognition, social cognition, clinical symptoms and phase of illness.
abstract: OBJECTIVE
  Impaired insight is an important and prevalent symptom of psychosis. It remains unclear whether cognitive disturbances hamper improvements in insight. We investigated the neurocognitive, social cognitive, and clinical correlates of changes in insight.
  
  
  METHODS
  One hundred and fifty-four patients with a psychotic disorder were assessed at baseline (T0 ) and after three years (T3 ) with the Birchwood Insight Scale, the Positive And Negative Syndrome Scale, measures of neurocognition and social cognition. Linear regression analyses were conducted to examine to what extend neurocognition, social cognition, clinical symptoms and phase of illness could uniquely predict insight change. Subsequently, changes in these factors were related to insight change.
  
  
  RESULTS
  Better neurocognitive performance and fewer clinical symptoms at baseline explained insight improvements. The additional effect of clinical symptoms over and above the contribution of neurocognition was significant. Together, these factors explained 10% of the variance. Social cognition and phase of illness could not predict insight change. Changes in clinical symptoms, but not changes in neurocognitive performance were associated with insight change.
  
  
  CONCLUSIONS
  Neurocognitive abilities may predict, in part, the development of insight in psychosis.
authors.affiliation: Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, the Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: Quee
authors.forename: L
authors.initials: L
authors.lastname: van der Meer
authors.forename: L
authors.initials: L
authors.lastname: Krabbendam
authors.forename: L
authors.initials: L
authors.lastname: de Haan
authors.forename: W
authors.initials: W
authors.lastname: Cahn
authors.forename: D
authors.initials: D
authors.lastname: Wiersma
authors.forename: N
authors.initials: N
authors.lastname: van Beveren
authors.forename: G H M
authors.initials: GH
authors.lastname: Pijnenborg
authors.forename: C L
authors.initials: CL
authors.lastname: Mulder
authors.forename: R
authors.initials: R
authors.lastname: Bruggeman
authors.forename: A
authors.initials: A
authors.lastname: Aleman
mesh_terms: D000328:Adult; D001364:Awareness; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012649:Self Concept; D012720:Severity of Illness Index; D012919:Social Behavior; D012938:Social Perception; D055815:Young Adult
keywords: GROUP-longitudinal; awareness; insight; neuropsychology; schizophrenia