Cognitive insight and dynamics of indicators of ultra-high risk for schizophrenia in young patients with non-psychotic forms of mental disorders

Abstract

Cognitive insight, although not linked to objective indicators of ultra-high risk for schizophrenia, predicts a decline in both total score of SOPS, and in the Positive symptoms subscale during the treatment of patients with personality disorders. In the groups with mood disorders and schizotypal disorder, cognitive insight reflects more anxiety and uncertainty related to patients' experience rather than the true conscious criticism. In the group with schizotypal disorder, it is also closely related to the severity of subjective psychopathological symptoms.

Cognitive insight in individuals with an at‐risk mental state for psychosis: A meta‐analysis

“…Five studies were eligible for our meta-analysis including 303 individuals with an ARMS status and 376 healthy controls (Clark, 2017;Kimhy et al, 2014;Ohmuro et al, 2018;Rasskazova et al, 2016;Uchida et al, 2014) (Table 1). All studies assessed insight abilities with a validated version of the BCIS (English (Clark, 2017;Kimhy et al, 2014), Japanese [Ohmuro et al, 2018;Uchida et al, 2014] and Russian [Rasskazova et al, 2016] languages). All participants were recruited from psychosis high-risk specialized clinics (ARMS) and from the community (controls).…”

“…The Baujat plots indicated that the study of Rasskazova et al (2016) largely influenced all summary-ESg and contributed to their heterogeneity (Figure S1). In addition, this study demonstrated the highest risk of bias (QualSyst total = 10/22) as compared to the other studies included in the meta-analysis (QualSyst total = 18-to-20/22).…”

“…Although neurocognitive and social deficits have been repeatedly demonstrated in ARMS (Fusar-Poli et al, 2012), it was originally stated that maintenance of relatively intact insight abilities is a key determinant that differentiates this category from fullblown psychotic disorders, which are, by contrast, characterized by poor levels of insight (Elowe & Conus, 2017). Since then, this assumption has been challenged by several investigations of cognitive insight abilities in ARMS (Clark, 2017;Kimhy et al, 2014;Ohmuro et al, 2018;Rasskazova et al, 2016;Uchida et al, 2014). Surprisingly, some authors have observed higher levels of overall cognitive insight in ARMS individuals compared to unaffected controls (Clark, 2017;Rasskazova et al, 2016), but this result was not replicated by other groups (Kimhy et al, 2014;Ohmuro et al, 2018;Uchida et al, 2014).…”

“…Since then, this assumption has been challenged by several investigations of cognitive insight abilities in ARMS (Clark, 2017;Kimhy et al, 2014;Ohmuro et al, 2018;Rasskazova et al, 2016;Uchida et al, 2014). Surprisingly, some authors have observed higher levels of overall cognitive insight in ARMS individuals compared to unaffected controls (Clark, 2017;Rasskazova et al, 2016), but this result was not replicated by other groups (Kimhy et al, 2014;Ohmuro et al, 2018;Uchida et al, 2014).…”

“…In addition, specific dimensions of cognitive insight (ie, self-reflectiveness and self-certainty) have been found either decreased (Rasskazova et al, 2016;Uchida et al, 2014) or increased (Clark, 2017;Rasskazova et al, 2016) in ARMS samples. Thus, taking into consideration, the growing interest for the clinical profiling of the ARMS and the clinical importance of insight in the onset and maintenance of fullthreshold psychosis, we conducted a meta-analysis of the literature to investigate whether cognitive insight deficits predate expression of psychosis and are already distinguishable between the at-risk population and healthy controls.…”