Neurocognitive basis of insight in schizophrenia

Mysore, Ashok; Parks, Randolph W.; Lee, Kwang-Hyuk; Bhaker, Rajinder S.; Birkett, Paul; Woodruff, Peter

doi:10.1192/bjp.bp.106.029181

Cited by 17 publications

(9 citation statements)

References 15 publications

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“…Thirdly, the absence of correlation between overall insight and executive function observed in this study contradicts the more recent cognitive accounts of insight [4,38] . It is not possible to explain this result, but it could be speculated that this sample was mostly composed of what some authors [39] have called the 'aware' and cognitively intact schizophrenia patients [4] .…”

Section: Discussioncontrasting

confidence: 55%

“…It is not possible to explain this result, but it could be speculated that this sample was mostly composed of what some authors [39] have called the 'aware' and cognitively intact schizophrenia patients [4] . It might also be that the lack of association between insight and executive function is due to the insight scale used in this study; most research on insight and its cognitive basis have used other instruments [9,40] which might be more sensitive to executive dysfunction.…”

Section: Discussionmentioning

confidence: 81%

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Formal Thought Disorder, Neuropsychology and Insight in Schizophrenia

2009

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Background: Information provided by patients with schizophrenia and their respective carers is used to study the descriptive psychopathology and neuropsychology of formal thought disorder (FTD). Sampling and Methods: Relatively intellectually preserved schizophrenia patients (n = 31) exhibiting from no to severe positive FTD completed a self-report scale of FTD, a scale of insight as well as several tests of executive and semantic function. The patients’ carers completed another scale of FTD to assess the patients’ speech. Results: FTD as self-reported by patients was significantly associated with the synonyms test performance and severity of the reality distortion dimension. FTD as assessed by a clinician and by the patients’ carers was significantly associated with executive test performance and performance in a test of associative semantics. Overall insight was significantly associated with severity of the reality distortion dimension and graded naming test performance, but was not associated with self-reported FTD or severity of FTD as assessed by the clinician or carers. Conclusions: The self-reported experience of FTD has different clinical and neuropsychological correlates from those of FTD as assessed by clinicians and carers. The assessment of FTD by patients and carers used along with the clinician’s assessment may further the study of this group of symptoms.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 81%

Formal Thought Disorder, Neuropsychology and Insight in Schizophrenia

2009

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“…For example, several studies demonstrated that greater clinical and cognitive insight was associated with better executive functioning (Aleman et al, 2006; Burton et al, 2011; Larøi et al, 2000; Medalia and Thysen, 2010; Monteiro et al, 2008; Mysore et al, 2007; Orfei et al, 2010; Shad et al, 2004; Simon et al, 2009), lending support to the view that poor insight in schizophrenia may be a function of specific prefrontally-mediated neurocognitive deficits rather than a global deficit in neuropsychological functioning (Shad et al, 2004). …”

Section: Introductionmentioning

confidence: 97%

Neurocognitive insight and objective cognitive functioning in schizophrenia

Burton

Harvey

Patterson

et al. 2016

Schizophrenia Research

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Neurocognitive impairment is a core component of schizophrenia affecting everyday functioning; the extent to which individuals with schizophrenia show awareness of neurocognitive impairment (neurocognitive insight) is unclear. This study investigated neurocognitive insight and examined the cross-sectional relationships between neurocognitive insight and objective neurocognition and functional capacity performance in a large outpatient sample. 214 participants with schizophrenia-spectrum disorders completed measures of neurocognition, functional capacity, and self-reported neurocognitive problems. Latent profile analysis classified participants with regard to neuropsychological performance and self-report of neurocognitive problems. The resulting classes were then compared on executive functioning performance, functional capacity performance, and psychiatric symptom severity. More than three quarters of the sample demonstrated objective neurocognitive impairment (global deficit score ≥ 0.50). Among the participants with neurocognitive impairment, 54% were classified as having “impaired” neurocognitive insight (i.e., reporting few neurocognitive problems despite having objective neurocognitive impairment). Participants with impaired vs. intact neurocognitive insight did not differ on executive functioning measures or measures of functional capacity or negative symptom severity, but those with intact neurocognitive insight reported higher levels of positive and depressive symptoms. A substantial portion of individuals with schizophrenia and objectively measured neurocognitive dysfunction appear unaware of their deficits. Patient self-report of neurocognitive problems, therefore, is not likely to reliably assess neurocognition. Difficulty self-identifying neurocognitive impairment appears to be unrelated to executive functioning, negative symptoms, and functional capacity. For those with intact neurocognitive insight, improving depressive and psychotic symptoms may be a valuable target to reduce illness burden.

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“…Finally, it has also been outlined that the differentiation of dimensions has received consistent support from factoranalytical studies, so that the use of global or more detailed scales should be determined by the clinical or research purposes. causes is central to the study hypothesis, besides having received increasing support Mysore et al, 2007).…”

Section: Concept and Measurementmentioning

confidence: 99%