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Abstract: Background: Lack of insight is recognized as a symptom that predisposes the individuals with psychosis to noncompliance
with the treatment, leading to poorer course of illness. This study aimed to explore baseline predictors
of disturbances on insight at follow-up.
Methods: Three insight dimensions (insight of: ‘mental illness’, ‘need for treatment’ and ‘the social consequences
of the disorder’)weremeasuredwith the Scale to Assess Unawareness of Mental Disorder (SUMD) in a cohort of
224 first-episode psychosis (FEP) patients at 3-year follow-up. Subgroups, good vs. poor insight,were compared
on baseline clinical, neuropsychological, premorbid and sociodemographic characteristics. Regression models
tested baseline predictors for each insight dimension.
Results: At 3-year follow-up a high percentage of patients, 45%, 36% and 33% for each dimension, were found to
remain lacking insight. Poor insight into having an illness was predicted by a diagnosis of schizophrenia and
poor baseline insight of the social consequences; insight into the need for treatmentwas predicted by adolescent
adjustment and depression at baseline; and insight into the social consequences of the disorder was determined
by late adolescent adjustment and baseline insight of mental illness.
Conclusions: Our findings support the hypothesis that long-terminsight in psychosis seems to be, to some extent,
determined from first presentation, showing trait-like properties. A subgroup of ‘lacking insight’ patients, which
is characterized by a diagnosis of schizophrenia, lower levels of premorbid adjustment and less severe depressive
symptoms at baseline might benefit fromspecial interventions targeted at enhancing insight fromtheir first contact
with psychiatric services.
Fuente: Schizophr Res. 2014 Aug;157(1-3):271-7
Año de publicación: 2014
Nº de páginas: 7
Tipo de publicación: Artículo de Revista
MARIA ROSA AYESA ARRIOLA
LÓPEZ MORÍÑIGO, JD
ROCIO PEREZ IGLESIAS
RODRÍGUEZ SÁNCHEZ, JOSÉ MANUEL
BENEDICTO CRESPO FACORRO