Assessment of insight in psychosis

Amador, Xavier; Strauss, David H.; Yale, Scott; Flaum, Michael; Endicott, Jean; Gorman, Jack M.

doi:10.1176/ajp.150.6.873

Cited by 912 publications

(129 citation statements)

References 13 publications

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“…This finding is in line with other published studies [39,43,44]. The modest percentage of the variance of insight explained by TMT B-A (9.0% for awareness of mental disorder scores) is also consistent with the existing literature [8,16,32].…”

Section: Discussionsupporting

confidence: 93%

“…Table 1 shows the percentage of subjects with each of the scores (1-5) in each of the three general SUMD dimensions. Using a score of 3 as a cut-off point [39,43] between 50 and 71% of our sample exhibited poor or absent insight.…”

Section: Resultsmentioning

confidence: 99%

“…In order to assess insight, the SUMD designed by Amador et al [39] was used in its validated Spanish version [40]. The SUMD is a semistructured interview assessing insight as a multidimensional phenomenon.…”

Section: Methodsmentioning

confidence: 99%

“…Then, assuming that SUMD variables are continuous and normally distributed, as indicated by Amador et al [39], the relationships between insight and the sociodemographic, clinical and neuropsychological variables were calculated using Pearson coefficients. Finally, we carried out a multiple regression analysis with the subcomponents of the general SUMD (dependent variables) and TMT B-A scores (independent variable) in a stepwise multiple linear regression model, with controlling for variables possibly inducing a confusing effect.…”

Section: Methodsmentioning

confidence: 99%

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Differential Relationships between Set-Shifting Abilities and Dimensions of Insight in Schizophrenia

et al. 2013

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Background: To assess insight in a large sample of patients with schizophrenia and to study its relationship with set shifting as an executive function. Methods: The insight of a sample of 161 clinically stable, community-dwelling patients with schizophrenia was evaluated by means of the Scale to Assess Unawareness of Mental Disorder (SUMD). Set shifting was measured using the Trail-Making Test time required to complete part B minus the time required to complete part A (TMT B-A). Linear regression analyses were performed to investigate the relationships of TMT B-A with different dimensions of general insight. Results: Regression analyses revealed a significant association between TMT B-A and two of the SUMD general components: ‘awareness of mental disorder' and ‘awareness of the efficacy of treatment'. The ‘awareness of social consequences' component was not significantly associated with set shifting. Conclusions: Our results show a significant relation between set shifting and insight, but not in the same manner for the different components of the SUMD general score.

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Section: Discussionsupporting

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Differential Relationships between Set-Shifting Abilities and Dimensions of Insight in Schizophrenia

et al. 2013

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“…the SUMD [13,14] and the 32-item Insight Scale (IS) [8], respectively. The SUMD is the most widely used clinician-rated scale to assess insight into illness.…”

Section: Methodsmentioning

confidence: 99%

Insight and Awareness as Related to Psychopathology and Cognition

et al. 2012

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Background: Insight affects adherence and treatment outcome and relates to cognitive impairment and psychopathology. We investigated the relationship of insight with cognition in patients with major depression, schizophrenia and bipolar disorder in acute psychiatric care, long-term inpatient, and outpatient settings. Methods: Eighty-one patients (women, 59.5%; age, 45.9 ± 13.5 years; 27 in each setting group; 33.3% with DSM-IV bipolar disorder, 39.5% with unipolar major depression, and 27.2% with schizophrenia) underwent the Wisconsin Card Sorting Test (WCST) to test flexibility, clinician-rated Scale to Assess Unawareness of Mental Disorder (SUMD), and self-rated Insight Scale (IS) to assess insight/awareness. Results: Poor performance on the WCST correlated with higher SUMD scores such as current psychiatric illness unawareness, impaired symptom attribution, unawareness of medication effect, or of social consequences, but not with IS scores. The latter correlated with days on continuous treatment. Patients receiving psycho-education showed greater symptom awareness compared to patients treated with drugs alone. Cognitive flexibility and diagnostic category did not correlate. Poor insight corresponded with severe mental illness, particularly acute psychosis. Conclusions: Treatment setting specificity reflects psychopathology and severity. Insight is inversely proportional to illness severity and cognitive flexibility, which is also affected by psychopathology. Limitations comprise group heterogeneity, cross-sectional design, and limited sample size.

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