Comparisons of insight in schizophrenia, bipolar I disorder, and depressive disorders with and without comorbid alcohol use disorder

Yen, Cheng Fang; Chen, Cheng Chung; Cheng, Chun‐Yu; Yen, Chia Nan; Lin, Hsiu-Hsia; Ko, Chih Hung; Yen, Ju-Yu

doi:10.1111/j.1440-1819.2008.01870.x

Cited by 17 publications

(11 citation statements)

References 26 publications

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“…Moreover, better insight was found to be associated with more depressive symptoms. Although this effect has been reported before (6,26,27,69,70), the underlying mechanism of this effect is not clear. Possibly patients with better insight have a more realistic representation of their own situation, which makes them more depressed.…”

Section: Insight and Clinical Characteristicsmentioning

confidence: 71%

Insight in bipolar disorder: associations with cognitive and emotional processing and illness characteristics

et al. 2011

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Section: Insight and Clinical Characteristicsmentioning

confidence: 71%

Insight in bipolar disorder: associations with cognitive and emotional processing and illness characteristics

et al. 2011

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“…Schizophrenia and bipolar disorder have been reported both to differ [31,32,33] and not to differ regarding insight [34,35,36]. Diagnosis appears to be relatively unimportant when measures like degree of psychosis [33] or symptom severity and cognitive impairment [35] are taken into account, but generally, patients with schizophrenia show less insight than other patients.…”

Section: Discussionmentioning

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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“…The term 'acceptance' is closer to the particular dimension of insight, mentioned above as 'awareness of the need for treatment' [38].…”

Section: From Insight To Acceptance In Capacity Assessmentsmentioning

confidence: 99%

Acceptance and insight: incapacity to give informed consent

Staden¹

2009

Current Opinion in Psychiatry

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Outline• Abstract • Introduction• Causal connection between mental disorder and particular inabilities• Insight, acceptance and appreciation in assessments of capacity to give informed consent • Connections between insight and incapacity• From insight to acceptance in capacity assessments • Conclusion• References and recommended reading AbstractPurpose of review: To highlight areas for potential refinement in assessments of capacity to give informed consent. Recent findings:The clinical assessment of the patient's capacity to give informed consent may be informed and guided by sophisticated criteria or assessment instruments. The approach of most assessment instruments and the literature on (in)capacity departs from the abilities that underpin giving informed consent. This approach may be refined, however, by assessing clinically for a causal connection between the mental disorder in the mind of a particular person and the particular inability. It may furthermore be refined by assessing that aspect of insight that is best connected to incapacity, for insight has been found to be the best clinical discriminator of capacity status in patients with psychotic and manic disorders. Summary:To find that a person is incapable by virtue of a mental disorder, a causal connection between the mental disorder and the particular inability should be assessed clinically for the very patient.Furthermore, the term 'acceptance' is more apt than 'appreciation' and 'belief' in capturing that aspect of insight by which a person with psychotic and manic disorders may be rendered incapable of giving informed consent.

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Comparisons of insight in schizophrenia, bipolar I disorder, and depressive disorders with and without comorbid alcohol use disorder

Cited by 17 publications

References 26 publications

Insight in bipolar disorder: associations with cognitive and emotional processing and illness characteristics

Insight in bipolar disorder: associations with cognitive and emotional processing and illness characteristics

Insight and Awareness as Related to Psychopathology and Cognition

Acceptance and insight: incapacity to give informed consent

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