Comparison of insight among schizophrenia and bipolar disorder patients in remission of affective and positive symptoms: Analysis and critique

Braw, Yoram; Sitman, Raquel; Sela, Tal; Erez, Galit; Bloch, Yuval; Levkovitz, Yechiel

doi:10.1016/j.eurpsy.2011.02.002

Cited by 31 publications

(21 citation statements)

References 43 publications

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“…The findings of studies reporting on the relationship between impaired insight and negative symptoms are also mixed. Impaired insight and negative symptoms are modestly associated in a number of cross‐sectional studies (Nakano et al ., ; De Hert et al ., ; Braw et al ., ; Chan et al ., ) and longitudinal studies (Kemp and Lambert, ; Saeedi et al ., ). Similarly, the results of a meta‐analysis found a modest but significant relationship between impaired insight and negative symptoms (Mintz et al ., ).…”

Section: Resultsmentioning

confidence: 98%

The effects of aging on insight into illness in schizophrenia: a review

Gerretsen

Plitman

Rajji

et al. 2014

Int J Geriat Psychiatry

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Objectives Impaired insight into illness is a prevalent feature of schizophrenia, which negatively influences treatment adherence and clinical outcomes. Little is known about the effects of aging on insight impairment. We aimed to review the available research literature on the effects of aging on insight into illness in schizophrenia, in relation to positive, negative, and cognitive symptoms. Ultimately, we propose a trajectory of insight in schizophrenia across the lifespan. Method A systematic Medline® literature search was conducted, searching for English language studies describing the relationship of insight into illness in schizophrenia with aging. Results We identified 62 studies. Insight impairment is associated with illness severity, premorbid intellectual function (i.e. IQ), executive function, and memory. Insight impairment improves modestly during midlife, worsening again in late life. It tends to fluctuate with each episode of psychosis, likely in relation to worsening positive symptoms that improve with antipsychotic treatment. The relationship between insight impairment and cognitive dysfunction appears to attenuate with age, while the relationship with lower premorbid intellectual function is preserved. The association between impaired insight and negative symptoms is unclear. Conclusions The available literature suggests that the course of insight impairment follows a U-shaped curve, where insight impairment is severe during the first episode of psychosis, modestly improves over midlife, and declines again in late life. Future studies are required to investigate the trajectory of insight into illness and its core domains across the lifespan from prodromal phase to late life.

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Section: Resultsmentioning

confidence: 98%

The effects of aging on insight into illness in schizophrenia: a review

Gerretsen

Plitman

Rajji

et al. 2014

Int J Geriat Psychiatry

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“…It has been found across cultures 6,7 , and in early as well as later [8][9][10][11] , and in acute as well as non-acute phases of illness 12 .…”

Section: (World Psychiatry 2018;17:12-23)mentioning

confidence: 99%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

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Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

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“…Dezessete estudos 11,[22][23][24][25][29][30][31][32][33][34][35][36][37][38][39][40] Três estudos investigaram a relação entre insight e a ocorrência prévia de sintomas psicóticos 17,46,50 . Um deles 50 relatou que menor insight sobre a doença estava associado a uma história de sintomas psicóticos.…”

Section: Comparação Entre O Tb E Outros Transtornos Mentaisunclassified

“…Pini et al 22 e Colis et al 23 relatam que o insight de pacientes com TB é semelhante ao de pacientes esquizofrênicos. Contudo, outros estudos 24,25 observaram que o insight em pacientes com TB era maior do que em esquizofrênicos. Também se torna importante discutir se a presença de sintomas psicóticos em fases agudas do TB pode influenciar o nível de insight.…”

Section: Introductionunclassified

O insight no transtorno bipolar: uma revisão sistemática

Silva

Mograbi²,

Landeira-Fernández

et al. 2014

J. bras. psiquiatr.

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rESUMo objetivos: Realizar uma revisão sistemática para compreender que fatores estão relacionados a uma maior ou menor consciência de morbidade no transtorno bipolar (TB), como o insight varia em função do estado afetivo e estabelecer uma comparação com outros transtornos mentais. Métodos: Realizou-se uma revisão sistemática da literatura científica sobre o insight em pacientes com TB. Foram buscados estudos clínicos originais sobre o tema nas bases de dados Medline, ISI e SciELO. Os termos de busca empregados foram: "insight" OR "awareness" AND "bipolar" OR "mania" OR "manic". resultados: Foram selecionados 55 artigos. O insight no TB parece ser mais prejudicado do que na depressão unipolar, porém menos do que na esquizofrenia. Com relação ao TB, um menor nível de insight está relacionado à presença de sintomas psicóticos e de alterações cognitivas. Além disso, um comprometimento do insight está associado a uma menor adesão ao tratamento. Por outro lado, uma maior preservação do insight pode estar associada a maior ideação suicida. Finalmente, a fase maníaca cursa com um nível inferior de insight quando comparada à fase depressiva ou de eutimia. Conclusão: No TB, o insight está significativamente prejudicado, especialmente na mania. Diversos fatores clínicos parecem influenciar o nível de insight. aBStraCt objectives: To conduct a systematic review to understand which factors are related to insight in bipolar disorder (BD), how insight varies depending on affective state and to establish a comparison between BD and other mental disorders. Methods: We performed a systematic review of the scientific literature on insight in BD patients. Clinical studies on the topic were searched in the Medline, SciELO and ISI databases. The search terms used were: "insight" OR "Awareness" AND "bipolar" OR "mania". results: Fifty-five articles were selected. Insight in BD is more compromised than in unipolar depression, but less than in schizophrenia. A lower level of insight is related to the presence of psychotic symptoms and cognitive disorders. Moreover, insight impairment is associated with lower adherence to treatment. On the other hand, a greater preservation of insight may be associated with increased suicidal ideation. Finally, the manic phase is characterized by a lower level of insight than the depressive phase or euthymia. Conclusion: Insight is greatly impaired in BD, especially during mania. Several clinical factors seem to influence the level of insight.

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Comparison of insight among schizophrenia and bipolar disorder patients in remission of affective and positive symptoms: Analysis and critique

Cited by 31 publications

References 43 publications

The effects of aging on insight into illness in schizophrenia: a review

The effects of aging on insight into illness in schizophrenia: a review

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

O insight no transtorno bipolar: uma revisão sistemática

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