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

Werf-Eldering, M. J. van der; Meer, Lisette van der; Burger, Huibert; Holthausen, E. A. E.; Nolen, Willem A.; Alemán, André

doi:10.1111/j.1399-5618.2011.00934.x

Cited by 38 publications

(33 citation statements)

References 77 publications

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“…Três estudos 46,49,50 observaram que uma maior duração ou idade de início da doença mais precoce estariam associadas a menor insight no TB. Esses dados também poderiam reforçar a ideia de que um maior período de convivência com a doença levaria a melhor conhecimento sobre sua sintomatologia.…”

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

“…Um deles 50 relatou que menor insight sobre a doença estava associado a uma história de sintomas psicóticos. Contudo, esse mesmo estudo 50 relatou que menor insight sobre sintomas estava associado à ausência de história de sintomas psicóticos. Outro estudo 46 relatou que menor insight sobre sintomas psicóticos estaria associado à história de sintomas psicóticos.…”

Section: Comparação Entre O Tb E Outros Transtornos Mentaisunclassified

“…Os nove estudos 17,36,38,45,47,50,55,64,67 sobre a relação entre o insight no TB e avaliações neuropsicológicas são apresentados na tabela 5.…”

Section: Avaliação Neuropsicológicaunclassified

“…Foram encontradas associações entre um menor insight e um maior comprometimento de memória 17,45,47,50 e de aprendizagem emocional 50 , de inteligência geral e de função psicomotora 36,64 , de compreensão e de habilidades perceptivo-motoras 17,47 , de atenção 17,36,64 , de fluência verbal 17,67 e de função executiva 17,45,47 , e ainda de maior velocidade de processamento 50 . 68 comparou eutímicos e deprimidos e relatou que insight dos eutímicos era igual ao dos deprimidos.…”

Section: Avaliação Neuropsicológicaunclassified

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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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Section: Discussionunclassified

Section: Comparação Entre O Tb E Outros Transtornos Mentaisunclassified

“…Os nove estudos 17,36,38,45,47,50,55,64,67 sobre a relação entre o insight no TB e avaliações neuropsicológicas são apresentados na tabela 5.…”

Section: Avaliação Neuropsicológicaunclassified

See 3 more Smart Citations

O insight no transtorno bipolar: uma revisão sistemática

Silva

Mograbi²,

Landeira-Fernández

et al. 2014

J. bras. psiquiatr.

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Socio-demographic and clinical characterization of patients with Bipolar Disorder I vs II: a Nationwide Italian Study

Altamura

Buoli

Cesana

et al. 2017

Eur Arch Psychiatry Clin Neurosci

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Bipolar disorders (BDs) are prevalent, comorbid and disabling conditions, associated with the highest suicide risk among psychiatric illnesses. In the last few years, new efforts to better characterize the socio-demographic and clinical profiles of BD type I vs II have been documented by several reports, with novel and insightful findings in the field. The present multicenter study aimed to provide a comprehensive and reliable representation of the Italian reality, through the analysis of the largest national sample of bipolar patients collected so far. A total of 1500 patients (BD I n = 963 and BD II n = 537) from different psychiatric departments, participating in the Italian Chapter of the "International Society of Bipolar Disorders" (ISBD), were assessed and divided into two groups on the basis of their diagnostic subtype, and different socio-demographic and clinical variables were compared between the two subgroups. Chi-squared tests for categorical variables and t tests for continuous variables were performed for group comparison. Furthermore, a multivariable logistic regression was performed, considering diagnostic bipolar subtype (type I or II) as dependent variable, and socio-demographic/clinical characteristics as independent variables. BD I vs II patients showed an overall less favorable socio-demographic and clinical profile. In addition, the multivariable logistic regression showed that BD II vs BD I was predicted by the absence of lifetime suicide attempts (OR = 1.58, p = 0.01), a later age of diagnosis (OR = 1.03, p < 0.01), less hypomanic episodes in the last year (OR = 2.29, p < 0.0001) and absence of psycho-educational interventions in the last year (OR = 0.51, p < 0.01). BD I and II patients were found to significantly differ in relation to specific clinical variables, which should be considered within updated diagnostic-therapeutic algorithms.

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Insight Across the Different Mood States of Bipolar Disorder

et al. 2015

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In bipolar disorder, levels of insight vary as a function of the mood state and appear to influence pharmacology compliance, quality of life, the presence of suicidal ideations, and aggressive behavior. To establish a comparison among different mood states in bipolar with regard to level of insight. Forty-eight patients were evaluated in different affective states (i.e., euthymia, mania, depression, and mixed state). Identifying information, sociodemographic data, and clinical records were recorded. The following scales were applied: Hamilton Depression Scale, Young Mania Rating Scale, Positive and Negative Syndrome Scale positive symptoms subscale, and Global Assessment of Functioning and Clinical Global Impressions Scale for use in bipolar disorder. Insight was evaluated using items 11 and 17 of the Young Mania Rating Scale and Hamilton Depression Scale, respectively. Insight in bipolar disorder was found to be more compromised during manic phases and mixed episodes than during periods of depression or euthymia. The factors associated with lower levels of insight were the following: shorter illness duration, older age, and greater severity in mania; the female gender and older age in depression; and shorter illness duration and more severe depressive symptoms in mixed episodes. In the same individual, levels of insight vary as a function of the affective state over the course of bipolar disorder and appear to be influenced by several clinical variables.

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

Abstract: Cognitive functioning as well as impairments in emotional learning and psychotic features independently contributes to impaired insight in bipolar disorder. Processing speed seems to be a key variable in the prediction of insight in patients with LPF and not in patients without LPF.

Cited by 38 publications

References 77 publications

O insight no transtorno bipolar: uma revisão sistemática

O insight no transtorno bipolar: uma revisão sistemática

Socio-demographic and clinical characterization of patients with Bipolar Disorder I vs II: a Nationwide Italian Study

Insight Across the Different Mood States of Bipolar Disorder

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