Clinical and cognitive insight in patients with acute-phase psychosis: Association with treatment and neuropsychological functioning.
BACKGROUND
The severity of psychopathology cannot fully explain deficits in the multi-dimensional construct of insight.


OBJECTIVE
The aim of this study was to evaluate the correlates and associations of clinical and cognitive insight in patients in an acute phase of psychosis and to analyse the impact of acute treatment on these variables.


METHODS
This study examined 47 inpatients who were recently hospitalized with acute exacerbation of schizophrenia. All subjects were assessed at both admission and discharge with the Positive and Negative Syndrome Scale (PANSS), Schedule for the Assessment of Insight-Expanded Version (SAI-E), Beck Cognitive Insight Scale (BCIS), and a neurocognition battery.


RESULTS
Patients with schizophrenia gained clinical insight after treatment. Cognitive insight did not change significantly after treatment. Insight showed significant negative correlations with positive symptoms and general psychopathology, but not with negative symptoms. Clinical insight was not associated with neuropsychological functioning in this cohort.


CONCLUSIONS
Gaining clinical insight in the acute phase of illness was associated with the remission of positive symptoms, but not with neuropsychological functioning. Some significant correlations between clinical and cognitive insights were detected, which suggests that cognitive insight contributes to clinical insight but is not treatment-dependent. Long-term treatment may be required to understand the contribution of insight to the outcome of patients with schizophrenia.
a Department of Psychiatry, Cerrahpaşa Faculty of Medicine , University of Istanbul , Istanbul , Turkey ;
Burç Çağri
BÇ
Poyraz
a Department of Psychiatry, Cerrahpaşa Faculty of Medicine , University of Istanbul , Istanbul , Turkey ;
Mehmet Kemal
MK
Arikan
a Department of Psychiatry, Cerrahpaşa Faculty of Medicine , University of Istanbul , Istanbul , Turkey ;
Cana Aksoy
CA
Poyraz
a Department of Psychiatry, Cerrahpaşa Faculty of Medicine , University of Istanbul , Istanbul , Turkey ;
Şenol
Ş
Turan
b Sivas Numune State Hospital , Sivas , Turkey.
Ayşe Sakalli
AS
Kani
a Department of Psychiatry, Cerrahpaşa Faculty of Medicine , University of Istanbul , Istanbul , Turkey ;
Eser
E
Aydin
a Department of Psychiatry, Cerrahpaşa Faculty of Medicine , University of Istanbul , Istanbul , Turkey ;
Ezgi
E
İnce
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition / Q000502:physiology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011618:Psychotic Disorders / Q000188:drug therapy / Q000503:physiopathology*; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D056345:Theory of Mind / Q000502:physiology*
Insight; acute psychosis; clinical insight; cognitive insight; schizophrenia