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Insight correlates in child- and adolescent-onset first episodes of psychosis: results from the CAFEPS study.

Abstract：

BACKGROUND:The correlates of insight in early-onset psychosis have received little previous attention. METHOD:We studied clinical correlates of insight in a sample of 110 adolescent recent-onset psychosis patients (mean age 15.53 years; psychotic symptoms present for <6 months). Insight was measured with the Scale to Assess Unawareness of Mental Disorder (SUMD) at baseline, 6 months and 12 months follow-up. RESULTS:Insight improved over the early phases of the illness, in parallel with psychopathological improvement. Poor insight at baseline and 6 months correlated with poor functioning at 6 and 12 months respectively. Schizophrenia patients had poorer insight than patients with bipolar disorder at 6 and 12 months but not at baseline. Logistic and linear regressions were used to predict 12-month diagnoses and functioning based on insight measurements. Baseline awareness of illness was a significant predictor for diagnosis [odds ratio (OR) 1.4, 95% confidence interval (CI) 1.05-1.97]. Treatment compliance at 6 months did not correlate with baseline SUMD subscores, but correlated with insight into having a disorder (Spearman's rho=0.21, p=0.039), its consequences (Spearman's rho=0.28, p=0.006) and the need for treatment (Spearman's rho=0.26, p=0.012) at 6 months. The 'attribution of symptoms' dimension of insight is poorly correlated with other insight dimensions and with other clinical variables. CONCLUSIONS:Poor insight correlates with symptom severity and global functioning but also has some trait value for schizophrenia, which is apparent once acute psychotic symptomatology is not prominent. A multi-dimensional approach to the assessment of insight is necessary, as different dimensions are influenced by different factors.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Parellada M,Fraguas D,Bombín I,Otero S,Castro-Fornieles J,Baeza I,Gonzalez-Pinto A,Graell M,Soutullo C,Paya B,Arango C

doi

10.1017/S0033291708004868

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

1433-45

issue

eissn

0033-2917

issn

1469-8978

pii

S0033291708004868

journal_volume

pub_type

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Insight correlates in child- and adolescent-onset first episodes of psychosis: results from the CAFEPS study.