title: Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST).
abstract: Although antipsychotics are widely prescribed, their effect of on improving poor illness insight in schizophrenia has seldom been investigated and therefore remains uncertain. This paper examines the effects of low dose haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on insight in first-episode schizophrenia, schizoaffective disorder, or schizophreniform disorder. The effects of five antipsychotic drugs in first episode psychosis on insight were compared in a large scale open randomized controlled trial conducted in 14 European countries: the European First-Episode Schizophrenia Trial (EUFEST). Patients with at least minimal impairments in insight were included in the present study (n=455). Insight was assessed with item G12 of the Positive and Negative Syndrome Scale (PANSS), administered at baseline and at 1, 3, 6, 9, and 12 months after randomization. The use of antipsychotics was associated with clear improvements in insight over and above improvements in other symptoms. This effect was most pronounced in the first three months of treatment, with quetiapine being significantly less effective than other drugs. Effects of spontaneous improvement cannot be ruled out due to the lack of a placebo control group, although such a large spontaneous improvement of insight would seem unlikely.
authors.affiliation: Department of Psychotic Disorders, GGZ-Drenthe, Assen, The Netherlands; Department of Psychology, University of Groningen, Groningen, The Netherlands; Neuroimaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: g.h.m.pijnenborg@rug.nl.
authors.forename: G H M
authors.initials: GH
authors.lastname: Pijnenborg
authors.affiliation: Department of Psychology, University of Groningen, Groningen, The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Timmerman
authors.affiliation: Academic Medical Center, Department of Psychiatry, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Derks
authors.affiliation: Department of Psychotherapy and Psychiatry, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: W W
authors.initials: WW
authors.lastname: Fleischhacker
authors.affiliation: Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: R S
authors.initials: RS
authors.lastname: Kahn
authors.affiliation: Department of Psychology, University of Groningen, Groningen, The Netherlands; Neuroimaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Aleman
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; Awareness; Insight; Psychoses; Schizophrenia