title: Depression and insight in schizophrenia: comparisons of levels of deficits in social cognition and metacognition and internalized stigma across three profiles.
abstract: While research has paradoxically linked insight to greater emotional distress and depression in schizophrenia, little is known why and for whom insight can result in depression. One possibility is that internalized stigma and deficits in social cognition and metacognition are risk factors for insight to convert to depression. To explore this possibility we assessed insight, depression, internalized stigma, social cognition and metacognition for sixty five persons with schizophrenia spectrum disorders. We then performed a cluster analysis based on insight and depression scores. Three groups were produced by the cluster analysis: Good insight/Mild depression (n=22); Fair insight/Moderate depression (n=26) and Poor insight/Minimal depression (n=17). As predicted, ANOVA comparing groups revealed the three groups differed in social cognition, and the metacognitive mastery aspect of metacognition. Those with fair insight and moderate depression reported more internalized stigma than those with poor insight and minimal depression. Persons with good insight and mild depression had higher levels of social cognition and metacognitive mastery than the other two groups. These differences persisted when controlling for neurocognition and symptom severity. These findings point to the possibility that future research should examine whether bolstering metacognitive and social cognitive capacities may have a protective effect as persons are assisted to achieve insight.
authors.affiliation: Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th St., Indianapolis, IN 46202, USA. plysaker@iupui.edu
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lysaker
authors.forename: Jen
authors.initials: J
authors.lastname: Vohs
authors.forename: Ilanit
authors.initials: I
authors.lastname: Hasson-Ohayon
authors.forename: Marina
authors.initials: M
authors.lastname: Kukla
authors.forename: Jena
authors.initials: J
authors.lastname: Wierwille
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Dimaggio
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001364:Awareness; D003072:Cognition Disorders / Q000209:etiology*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D057545:Social Stigma