Insight and Neuropsychological Function in Patients with Schizophrenia and Bipolar Disorder with Psychotic Features

Arduini, Luca; Kalyvoka, Artemis; Stratta, Paolo; Rinaldi, Osvaldo; Daneluzzo, E.; Rossi, Alessandro

doi:10.1177/070674370304800510

Cited by 65 publications

(52 citation statements)

References 26 publications

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“…To our knowledge, nineteen studies with available data have compared bipolar patients to schizophrenic patients on this test. Nine studies did not find any difference between the two groups, suggesting that cognitive inflexibility, linked to prefrontal cortical dysfunction, is not specific to SZ [38, 44, 46, 52, 65, 70, 82, 84, 85]. The small effect sizes (range: 0.10–0.44) confirm that the differences between the diagnostic groups are subtle.…”

Section: Resultsmentioning

confidence: 96%

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Daban

Martínez-Àran

Torrent

et al. 2006

Psychother Psychosom

184

138

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Background: More and more epidemiological, genetic and neuroimaging studies show similarities between bipolar disorder (BD) and schizophrenia (SZ). Cognitive functions are known to be highly impaired in SZ and are increasingly studied in BD. When both populations are compared, the conclusions appear to be contradictory. The purpose of this review is to help define the profile of cognitive deficits in BD and in SZ. Methods: A systematic review of the literature of neuropsychological studies comparing BD and SZ was made, beginning in January 1990 and ending in January 2005. Thirty-eight studies met the required quality criteria and were included in this review. Results: Bipolar patients exhibit extensive cognitive abnormalities with a pattern of deficits that is not unique to this disease. However, when compared to schizophrenic patients, bipolar patients demonstrate a lesser degree of deficits, particularly concerning premorbid and current intelligence quotient and perhaps attention, verbal memory and executive functions. When looking into effect sizes, there seem to be different profiles even in studies finding no significant differences. Conclusions: The neuropsychological differences reported between both groups could be due to the presence of psychotic features, to environmental factors (stressful events, duration of the disease and number of hospitalisations) and could also be related to differences during the neurodevelopmental phase. Further studies should confirm whether these results are truly related to different neurobiological backgrounds.

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Section: Resultsmentioning

confidence: 96%

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Daban

Martínez-Àran

Torrent

et al. 2006

Psychother Psychosom

184

138

View full text Add to dashboard Cite

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“…Contudo, alguns estudos encontraram níveis de insight semelhantes na comparação entre esquizofrênicos e bipolares 11,22,23,31,[36][37][38][39] . É importante ressaltar que alguns desses estudos que não distinguiram TB de esquizofrenia utilizaram uma amostra de bipolares com sintomas psicóticos 11,22,38 . Além disso, conforme discutido, a presença de sintomas psicóticos parece ter grande influência sobre o insight 18,65 .…”

Section: Discussionunclassified

“…Dezessete estudos 11,[22][23][24][25][29][30][31][32][33][34][35][36][37][38][39][40] Três estudos investigaram a relação entre insight e a ocorrência prévia de sintomas psicóticos 17,46,50 . Um deles 50 relatou que menor insight sobre a doença estava associado a uma história de sintomas psicóticos.…”

Section: Comparação Entre O Tb E Outros Transtornos Mentaisunclassified

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O insight no transtorno bipolar: uma revisão sistemática

Silva

Mograbi²,

Landeira-Fernández

et al. 2014

J. bras. psiquiatr.

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rESUMo objetivos: Realizar uma revisão sistemática para compreender que fatores estão relacionados a uma maior ou menor consciência de morbidade no transtorno bipolar (TB), como o insight varia em função do estado afetivo e estabelecer uma comparação com outros transtornos mentais. Métodos: Realizou-se uma revisão sistemática da literatura científica sobre o insight em pacientes com TB. Foram buscados estudos clínicos originais sobre o tema nas bases de dados Medline, ISI e SciELO. Os termos de busca empregados foram: "insight" OR "awareness" AND "bipolar" OR "mania" OR "manic". resultados: Foram selecionados 55 artigos. O insight no TB parece ser mais prejudicado do que na depressão unipolar, porém menos do que na esquizofrenia. Com relação ao TB, um menor nível de insight está relacionado à presença de sintomas psicóticos e de alterações cognitivas. Além disso, um comprometimento do insight está associado a uma menor adesão ao tratamento. Por outro lado, uma maior preservação do insight pode estar associada a maior ideação suicida. Finalmente, a fase maníaca cursa com um nível inferior de insight quando comparada à fase depressiva ou de eutimia. Conclusão: No TB, o insight está significativamente prejudicado, especialmente na mania. Diversos fatores clínicos parecem influenciar o nível de insight. aBStraCt objectives: To conduct a systematic review to understand which factors are related to insight in bipolar disorder (BD), how insight varies depending on affective state and to establish a comparison between BD and other mental disorders. Methods: We performed a systematic review of the scientific literature on insight in BD patients. Clinical studies on the topic were searched in the Medline, SciELO and ISI databases. The search terms used were: "insight" OR "Awareness" AND "bipolar" OR "mania". results: Fifty-five articles were selected. Insight in BD is more compromised than in unipolar depression, but less than in schizophrenia. A lower level of insight is related to the presence of psychotic symptoms and cognitive disorders. Moreover, insight impairment is associated with lower adherence to treatment. On the other hand, a greater preservation of insight may be associated with increased suicidal ideation. Finally, the manic phase is characterized by a lower level of insight than the depressive phase or euthymia. Conclusion: Insight is greatly impaired in BD, especially during mania. Several clinical factors seem to influence the level of insight.

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“…Lack of insight is not only found in schizophrenia, but can also be found in other psychotic disorders and in psychotic mood disorders [9][10][11][12]. Neurocognitive deficits have been described both in schizophrenia and mood disorders, and have been proposed to reflect underlying neurobiological dysfunction [13].…”

Section: Introductionmentioning

confidence: 99%

First and third person perspectives in psychotic disorders and mood disorders with psychotic features

Islam¹,

Demartini²,

Selle³

et al. 2011

International Clinical Psychopharmacology

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Lack of insight, very frequent in schizophrenia, can be considered a deficit in Theory of Mind (ToM) performances, and is also found in other psychiatric disorders. In this study, we used the first-to third-person shift to examine subjects with psychotic and psychotic mood disorders. 92 patients were evaluated with SANS and SAPS scales and asked to talk about their delusions. They were asked to state whether they thought what they said was believable for them and for the interviewer. Two weeks later, 79 patients listened to a tape where their delusion was reenacted by two actors and were asked the same two questions. Some patients gained insight when using third-person perspective. These patients had lower SAPS scores, a lower score on SAPS item on delusions, and significant improvement in their SAPS delusion score at the second interview. Better insight was not related to a specific diagnostic group.

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Insight and Neuropsychological Function in Patients with Schizophrenia and Bipolar Disorder with Psychotic Features

Abstract: The 3 insight dimensions (that is, awareness of mental disorder, awareness of social consequences of mental disorder, and awareness of the benefits of medication) do not appear to be associated with frontal impairment, as measured by the WCST.

Cited by 65 publications

References 26 publications

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

O insight no transtorno bipolar: uma revisão sistemática

First and third person perspectives in psychotic disorders and mood disorders with psychotic features

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