Effects of antipsychotic drugs on insight in schizophrenia

Bianchini, O.; Porcelli, Stefano; Nespeca, Claudia; Cannavò, D.; Trappoli, Angela; Aguglia, Eugenio; Ronchi, Diana De; Serretti, Alessandro

doi:10.1016/j.psychres.2014.03.022

Cited by 11 publications

(10 citation statements)

References 39 publications

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“…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%

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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Section: Insight and Outcomementioning

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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“…This trial compared the effects of two antipsychotics and found that olanzapine and haloperidol showed positive effects of about equal size on insight in psychosis (McEvoy et al, 2006). Recently, a small scale 'switch' study showed that Olanzapine, Aripiprazole and Ziprasidone lead to a larger increase in insight than haloperidol (Bianchini et al, 2014). There is also some evidence from uncontrolled trials that clozapine and other atypical agents increase insight (e.g., Pallanti et al, 1999;Kim et al, 2011;Wiffen et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

Pijnenborg¹,

Timmerman²,

Derks³

et al. 2015

European Neuropsychopharmacology

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“…The author defined insight as a construct of three overlapping dimensions: 'the recognition that one has a mental illness, compliance with treatment, and the ability to relabel unusual mental events as pathological'. However, the effects of antipsychotics on insight have been addressed only in a few studies including one study on first-episode psychosis patients (Pallanti et al, 1999;Kim et al, 2011;Bianchini et al, 2014;Pijnenborg et al, 2015). The analysis of data from the European First-Episode Schizophrenia Trial (EUFEST) showed that antipsychotic treatment is associated with a significant improvement in insight as measured by the G12 item of the Positive And Negative Syndrome Scale (PANSS), especially during the first 3 months of treatment (Pijnenborg et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…The authors also found that quetiapine might be significantly less effective than amisulpride, haloperidol, olanzapine and ziprasidone with respect to insight improvement. Another randomized study with a 6-month follow-up indicated that haloperidol might be less beneficial than aripiprazole, olanzapine and ziprasidone in terms of insight improvement (Bianchini et al, 2014). In turn, uncontrolled trials have shown both a beneficial effect of clozapine on insight (Pallanti et al, 1999) and a lack of significant differences between clozapine and other atypical antipsychotics with respect to insight improvement (Kim et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…In turn, uncontrolled trials have shown both a beneficial effect of clozapine on insight (Pallanti et al, 1999) and a lack of significant differences between clozapine and other atypical antipsychotics with respect to insight improvement (Kim et al, 2011). It should be noted that the majority of previous studies have not investigated as to whether antipsychotics directly influence illness insight or whether this mechanism appears secondary to their effects on psychopathological symptoms (Pallanti et al, 1999;Kim et al, 2011;Bianchini et al, 2014). Only the EUFEST study has addressed this issue, showing that the effects of antipsychotics on insight occurred over and above changes in global psychopathology (Pijnenborg et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Effects of antipsychotics on insight in schizophrenia

Misiak

Frydecka

Beszłej

et al. 2016

International Clinical Psychopharmacology

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We aimed to investigate whether antipsychotics differentially impact insight and whether these effects appear because of improvement in psychopathological manifestation in 132 first-episode schizophrenia patients and 201 acutely relapsed schizophrenic patients, who were followed up for 12 weeks. Olanzapine and risperidone were administered to first-episode schizophrenia patients, whereas acutely relapsed schizophrenic patients were treated with olanzapine, perazine and ziprasidone. The Positive And Negative Syndrome Scale (PANSS) was used to assess psychopathology. Insight was assessed using the G12 item of PANSS. Unadjusted mixed-model regression analysis indicated a significant improvement in the PANSS G12 item score in both groups. There were no significant differences between distinct treatment subgroups of patients in terms of improvement in the PANSS G12 item score. After adjustment for the trajectories of changes in symptom dimensions, a decrease in the PANSS G12 item score was because of an improvement in positive, negative and excitement symptoms. A decrease in the PANSS G12 item score was also related to an increase in the severity of depressive symptomatology. Our results indicate that antipsychotics exert similar effects on insight in acute psychosis. These effects are likely because of an improvement in psychopathological manifestation. The improvement in insight might be related to the development of depressive symptoms.

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Effects of antipsychotic drugs on insight in schizophrenia

Cited by 11 publications

References 39 publications

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

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

Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

Effects of antipsychotics on insight in schizophrenia

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