Can cognitive insight predict symptom remission in a first episode psychosis cohort?
The outcome of first episode psychosis (FEP) is highly variable and difficult to predict. Cognitive insight measured at illness onset has previously been found to predict psychopathology 12-months later. The aims of this study were to examine whether the prospective relationship between cognitive insight and symptom severity is evident at four-years following FEP and to examine some psychological correlates of cognitive insight.



FEP participants (n = 90) completed the Beck Cognitive Insight Scale (BCIS) at illness onset, and associations between BCIS scores with symptom severity outcomes (4-years after FEP) were assessed. The BCIS scales (self-reflectiveness and self-certainty) were examined as a composite score, and individually compared to other cognitive measures (IQ and jumping to conclusions (JTC) bias).



Regression analyses revealed that the cognitive insight composite did not predict 4-year symptom remission in this study while the self-reflection subscale of the BCIS predicted severity of symptoms at 4-years. Self-certainty items of the BCIS were not associated with symptom severity. Significant correlations between the JTC bias, self-certainty and IQ were found, but self-reflection did not correlate with these other cognitive measures.



Self-reflective capacity is a more relevant and independent cognitive construct than self-certainty for predicting prospective symptom severity in psychosis. Improving self-reflection may be a useful target for early intervention research.
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK. jennifer.1.o'connor@kcl.ac.uk.|Department of Psychology, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK. jennifer.1.o'connor@kcl.ac.uk.
Jennifer A
JA
O'Connor
Department of Psychology, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK.
Lyn
L
Ellett
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Olesya
O
Ajnakina
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Tabea
T
Schoeler
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Anna
A
Kollliakou
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Antonella
A
Trotta
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Benjamin D
BD
Wiffen
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Aurora M
AM
Falcone
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Marta
M
Di Forti
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Robin M
RM
Murray
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Sagnik
S
Bhattacharyya
Department of Psychosis Studies, P068, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
Anthony S
AS
David
D000328:Adult; D001364:Awareness; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D011618:Psychotic Disorders / Q000523:psychology*; D012044:Regression Analysis; D012649:Self Concept