Abstract: Insight has been considered a core symptom of psychosis and closely related to functional outcome. However, little is known regarding the role of insight and its progression in different long-term functioning subdomains among First Episode Psychosis (FEP) patients. A total of 209 participants were followed up over a 10-year period. Latent class mixed models were used to identify trajectory classes in each of the three different insight dimensions. Multivariate analyses were performed to explore predictive value of insight dimensions and its long-term trajectories in psychosocial functioning over a 10-year follow-up period including in the analyses a complete set of baseline and follow-up measures. Three different trajectories (improvement, continued awareness, and worsening) were differentiated in each of the insight dimensions, resulting continued awareness the most common trajectory. Awareness into mental illness at baseline represented one of the main predictors of very long-term instrumental and global functioning. Moreover, enhancement/maintenance of illness awareness was significantly related to better interpersonal functioning. Early intervention programs that promote the acquisition of awareness in the very early stages of the psychotic disorder could have a relevant impact on long-term functioning in FEP patients. Insight dimensions showed mostly trait-like properties although a considerable proportion of FEP patients experienced changes in insight dimensions over the follow-up period. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

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