title: A multi-dimensional approach to insight and its evolution in first-episode psychosis: a 1-year outcome naturalistic study.
abstract: The aim of the study was to describe the evolution of the different dimensions of insight at 1 year and its associations with psychopathology and symptomatic remission. Participants included 55 patients hospitalized for a first psychosis episode and followed up at 6 and 12 months after discharge. Measures included the Scale to Assess Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale (PANSS). Six dimensions of insight were evaluated, for current episode at hospital discharge and at 6 and 12 month FUs and past episode (at 6 and 12 month follow-ups). Our results show that concerning the current episode, only awareness of the social consequences and of the positive symptoms significantly improved during follow-up. Insight into the past episode improved for awareness of having a mental disorder, the social consequences and the positive symptoms of mental illness. Cross-sectional associations between insight and PANSS show weak to moderate, albeit significant, associations. Most of the dimensions of insight are positively and significantly associated with remission. Our findings suggest that the main underlying dimensions of insight evolve differently over time, which could suggest different inherent processes. This could be useful for developing psychotherapeutic programmes acting upon the different aspects of insight.
authors.affiliation: University Department of Adult Psychiatry, CHU Montpellier, University Montpellier 1, Hôpital la Colombière, 39 avenue Charles Flahault, 34295 Montpellier cedex 5, France; INSERM U1061, Hôpital la Colombière, Pavillon 42, 39 avenue Charles Flahault, 34295 Montpellier, France. Electronic address: delphine.capdevielle@free.fr.
authors.forename: Delphine
authors.initials: D
authors.lastname: Capdevielle
authors.forename: Joanna
authors.initials: J
authors.lastname: Norton
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.forename: Cindy
authors.initials: C
authors.lastname: Prud'homme
authors.forename: Stéphane
authors.initials: S
authors.lastname: Raffard
authors.forename: Françoise
authors.initials: F
authors.lastname: Gelly
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Boulenger
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
mesh_terms: D000293:Adolescent; D000328:Adult; D001364:Awareness; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011599:Psychopathology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology*; D055815:Young Adult
keywords: First psychosis episode; Insight; Remission; SUMD