The association of lifetime insight and cognition in psychosis

Sánchez‐Torres, Ana M.; Zarzuela, Amalia; Peralta, Víctor; Cuesta, Manuel J.

doi:10.1016/j.schres.2014.12.019

Cited by 9 publications

(9 citation statements)

References 36 publications

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“…A lack of insight into the illness is the main cause of treatment non‐adherence in patients with schizophrenia . In FEP patients, a negative attitude to medication predicts non‐adherence . In our study, we found significant differences in insight between the four clusters, but none in the case of adherence.…”

Section: Discussioncontrasting

confidence: 48%

Personalized medicine begins with the phenotype: identifying antipsychotic response phenotypes in a first‐episode psychosis cohort

Mas

Gassó

Rodríguez

et al. 2019

Acta Psychiatr Scand

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PEPs group. Personalized medicine begins with the phenotype: identifying antipsychotic response phenotypes in a first-episode psychosis cohort.Aims: Here, we present a clustering strategy to identify phenotypes of antipsychotic (AP) response by using longitudinal data from patients presenting first-episode psychosis (FEP). Method: One hundred and ninety FEP with complete data were selected from the PEPs project. The efficacy was assessed using total PANSS, and adverse effects using total UKU, during one-year follow-up. We used the Klm3D method to cluster longitudinal data. Results: We identified four clusters: cluster A, drug not toxic and beneficial; cluster B, drug beneficial but toxic; cluster C, drug neither toxic nor beneficial; and cluster D, drug toxic and not beneficial. These groups significantly differ in baseline demographics, clinical, and neuropsychological characteristics (PAS, total PANSS, DUP, insight, pIQ, age of onset, cocaine use and family history of mental illness). Conclusions:The results presented here allow the identification of phenotypes of AP response that differ in well-known simple and classic clinical variables opening the door to clinical prediction and application of personalized medicine.

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Section: Discussioncontrasting

confidence: 48%

Personalized medicine begins with the phenotype: identifying antipsychotic response phenotypes in a first‐episode psychosis cohort

Mas

Gassó

Rodríguez

et al. 2019

Acta Psychiatr Scand

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“…Deficits in social cognition have been proposed to contribute to poor clinical insight when they block the opportunity to use the perspectives of others to understand past and present evidence of mental illness 139 . Consistent with this, Sanchez-Torres et al 51 reported that poor lifetime insight in psychosis was related to poorer social cognition.…”

Section: Social Cognition As a Root Of Poor Insightmentioning

confidence: 66%

“…Other published studies continue to fail to find a link between insight and multiple facets of neurocognition in patients in varying phases of illness 47,51,133,134 .…”

Section: World Psychiatry 17:1 -February 2018mentioning

confidence: 99%

“…Literature supporting this includes studies correlating poor clinical insight with overall symptom severity [43][44][45] , positive symptoms 46,47 , negative symptoms 44,48,49 , disorganization symptoms 46,47,[50][51][52] , and excitement symptoms 46,47,53 . Of these studies, one was specific to first-episode psychosis 49 , while others examined patients with comorbid trauma 49,52 .…”

Section: Insight and Outcomementioning

confidence: 99%

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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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“…Based on the previously reported association between insight and social cognition [34], the PANSS item "lack of insight" was also independently used to test such association.…”

Section: Assessmentsmentioning

confidence: 99%

The role of schizotypal traits and the OXTR gene in theory of mind in schizophrenia: A family-based study

et al. 2020

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Background. There is consistent evidence that theory of mind (ToM) is impaired in schizophrenia (SZ); however, it remains unclear whether such deficits are trait- or state-dependent. We evaluated ToM in patients with schizophrenia spectrum disorders (SSDs), their healthy first-degree relatives, and controls to test its suitability as an endophenotypic marker. We also studied the modifying effect of markers of clinical and genetic liability to SZ (schizotypy and genetic variability in the oxytocin receptor gene: OXTR) on ToM in healthy individuals. Methods. The sample included 38 stable SSD patients, 80 unaffected first-degree relatives, and 81 controls. ToM was assessed using the Hinting Task (HT) and schizotypy via the Schizotypal Personality Questionnaire-Brief (SPQ-B), which generates interpersonal (SPQ-IP), cognitive-perceptual (SPQ-CP), and disorganization (SPQ-D) scores. The polymorphism rs53576 of OXTR was genotyped. Results. Patients presented poorer HT performance than relatives and controls (p = 0.003 and p < 0.001). High SPQ-IP and SPQ-CP scores correlated with poorer ToM performance in relatives (p = 0.010 and p = 0.030), but not in controls. OXTR was not associated with HT scores, but it showed a modifying effect within controls; high SPQ-CP was related to HT poorer performance conditional to GG genotype (p = 0.007). Conclusions. ToM deficits were present in patients but not in unaffected relatives or controls. However, our data indicate the usefulness of clinical and genetic liability markers to characterize differences in ToM abilities within healthy individuals. Then, the observed link between ToM and SZ liability suggests the putative role of ToM as an endophenotypic marker. Nevertheless, new analyses in larger samples are needed.

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The association of lifetime insight and cognition in psychosis

Cited by 9 publications

References 36 publications

Personalized medicine begins with the phenotype: identifying antipsychotic response phenotypes in a first‐episode psychosis cohort

Personalized medicine begins with the phenotype: identifying antipsychotic response phenotypes in a first‐episode psychosis cohort

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

The role of schizotypal traits and the OXTR gene in theory of mind in schizophrenia: A family-based study

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