Insight, psychopathology and global functioning in schizophrenia in urban Malawi

Crumlish, Niall; Samalani, Prince; Sefasi, Anthony; Kinsella, Anthony; O’Callaghan, Eadbhard; Chilale, Harris K

doi:10.1192/bjp.bp.107.036673

Cited by 16 publications

(15 citation statements)

References 12 publications

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“…More specifically, consistent with an extant literature [7,22,[24][25][26] insight was positively correlated with the overall level of functioning and severity of psychopathology as measured by the global functioning scale (GAF). In the light of other studies that have reported an inverse relationship between severity of psychopathology and level of insight [8,21,30,53], such discrepancies could be explained by the inconsistency found in the operational definition of insight [36] and functional outcomes (i.e., studies may explore general level of functioning or more specific aspects, e.g., occupational and social functioning), compounded by small or heterogeneous sample characteristics (e.g., current clinical state) and clinical scales used amongst studies [18,23].…”

Section: Discussionsupporting

confidence: 74%

“…However, despite the proliferation of work in this area, the nature of the relationship between insight and neurocognitive impairment, severity of psychopathology or functional recovery still remains unclear [19][20][21][22][23]. On cross-sectional analyses, lack of insight has been closely linked to poor global functioning [24][25][26], and poor treatment compliance [27,28].…”

Section: Introductionmentioning

confidence: 96%

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Insight, Global Functioning and Psychopathology Amongst In-patient Clients with Schizophrenia

Stefanopoulou

Lafuente²,

Fonseca³

et al. 2009

Psychiatr Q

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To explore whether cognitive impairment and global functioning can predict the degree of insight into illness as well as whether insight is mediated by specific symptom dimensions of psychopathology in schizophrenia. A dimensional/cross sectional approach was used. A mixed group of clients (n = 36) were assessed as part of a routine clinical evaluation. The Wechsler Adult Intelligence Scale (WAIS) was used as a measure of intellectual performance, the Brief Symptom Inventory (BSI) was used as a measure of general psychopathology while the Global Assessment of Functioning (GAF) scale assessed clients' psychosocial functioning; insight was assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ). The correlation matrix of all outcome variables was examined; confounding effects of illness duration were tested by partial correlation analyses. GAF correlated with insight (rho = 0.41, P = 0.01) and the interpersonal sensitivity dimension of BSI (rho = -0.38, P = 0.03. Insight correlated positively with the anxiety (rho = 0.38, P = 0.03) and psychoticism (rho = 0.36, P = 0.04) dimensions of BSI. Our results suggest that insight is part of the phenomenology in schizophrenia, not being determined by neurocognitive disturbances. Improved insight was associated with more frequent psychotic symptoms endorsement, higher levels of anxiety and less severe psychopathological symptoms and difficulties in psychosocial functioning; clients with more pronounced difficulties in their personal and social interactions exhibited worse psychosocial functioning and more severe psychopathological symptoms.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 96%

Insight, Global Functioning and Psychopathology Amongst In-patient Clients with Schizophrenia

Stefanopoulou

Lafuente²,

Fonseca³

et al. 2009

Psychiatr Q

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“…For instance, a multicentre study conducted among 524 patients with schizophrenia on oral and long acting olanzapine using a different instrument reported that majority of their subjects had impairment with a fifth of them having good level of functioning [25]. Other studies have reported similar range of figures among people with schizophrenia with regards to functioning using the same instrument [36], or with the use of different instrument [37]. Generally, recent findings suggest a relatively better level of functioning in a large proportion of individuals with schizophrenia when compared to the traditional Kraepelin classification [26], and the difference is possibly due to advancement in treatment.…”

Section: Psychopathology and Impairment With Associated Factorsmentioning

confidence: 65%

“…Previous research works on schizophrenia have indicated strong linkage between increasing frequency of symptoms with poorer level of functioning. Arguably, there is established relationship between functioning and lower severity of schizophrenic symptoms, greater levels of productive activity and higher scores on other health-related QOL measures [37]. Similarly, positive correlation between reduced psychopathology and increasing GAF score i.e.…”

Section: Psychopathology and Impairment With Associated Factorsmentioning

confidence: 99%

Assessment of Functioning among Nigerians with Schizophrenia in a Tertiary Health Facility: Influence of Psychopathology, Socio-demographic and Treatment Factors

Campbell

Olagunju

Aina

et al. 2015

J. Psychosoc. Rehabil. Ment. Health

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To investigate the profile of functional impairment and the influence of psychopathology with other determinants among individuals with schizophrenia in a Nigerian tertiary health facility. The study participants consisted of one hundred adults with schizophrenia. Eligible participants were recruited using systematic random sampling technique. All participants were interviewed with questionnaire to elicit socio-demographic and treatment related information. This was followed by interview with brief psychiatric rating scale (BPRS) and the global assessment of functioning (GAF) to assess for psychopathology and impairment in functioning respectively. Analyses of data were done using SPSS-16. The mean age of the participants was 33.87(±11.6) years and a little above half (52 %) of the participants were female. Sixty (60 %) subjects had active psychopathology using BPRS cut-off score of [10; while participants with duration of illness of more than 10 years (X 2 = 5.59, p = 0.018) and previous relapse (X 2 = 6.34, p = 0.012) were more likely to have psychopathology. Overall, a little over two-thirds (69 %) had impairment following administration of GAF. Mild impairment was observed in 23 % of the participants, moderate impairment in 19 and up to 18 % of participants had severe impairment due to psychopathology. Subjects with lesser education, duration of illness of more than 10 years, extrapyramidal side effects (EPSE), previous relapse and psychopathology had significant levels of impairment (p \ 0.05). However, it was education (Odds ratio [OR] = 0.060; 95 % Confidence interval [95 % CI] = 0.055, 0.770; p = 0.031), psychopathology (OR 5.265; 95 % CI 2.744, 13.626; p \ 0.001) and EPSE (OR 0.183; 95 % CI 0.049, 0.939; p = 0.043) that were independently associated with impairment in functioning following logistic regression to control for effects of confounders. In this study, varied degrees of impairment in functioning were prevalent among individuals with schizophrenia under treatment. However, those with lesser education, EPSE, active psychopathology and longer duration of illness were more likely to be impaired. Thus, better attention to the management of active psychopathology and prevention of extra-pyramidal side effects are indicated in order to promote improve functioning in schizophrenia. In addition, promotion of recovery oriented psychosocial services with need-based rehabilitation program for individuals with schizophrenia is advocated. There is need for more research on predictors of functioning towards promotion of evidence based rehabilitation.

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“…Während dieses Vorgehen bei Patienten mit guter Krankheits-und Behandlungseinsicht geradezu eingefordert wird und sie sich zusätzlich Spezialwissen aus dem Internet herunterladen (Crumlish et al 2007;Freyberger u. Schneider 2011), lehnen Patienten mit der gegenteiligen Krankheitseinstellung die kooperative Zusammenarbeit mit den professionellen Helfern oftmals kategorisch ab. Um mit diesen Patienten über ein verbessertes Wissen in einen konstruktiven Dialog treten zu können, zählen neben einer intensiven Beziehungsarbeit insbesondere psychoedukative Gruppen im stationären Bereich mittlerweile zum Behandlungsstandard (American Psychiatric Association 2006;Bäuml 2008;Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde 2006).…”

Section: Mangelnde Krankheits-und Behandlungseinsichtunclassified

Partizipationsverhalten schizophren erkrankter Patienten in Psychoedukationsgruppen

et al. 2012

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Angesichts des komplexen Krankheitsprozesses bei Schizophrenie muss bei einem Großteil der Patienten zunächst von einer als physiologisch zu bezeichnenden Wissensasymmetrie bezüglich der Erkrankung und der erforderlichen Behandlungsmaßnahmen ausgegangen werden. Hier eignen sich psychoedukative Gruppenprogramme, um das Wissen der Patienten zu verbessern und einen konstruktiven Dialog zwischen Patient und Behandler zu ermögli-chen. Über die Wirkmechanismen psychoedukativer Interventionen liegen bisher noch wenige Erkenntnisse vor. Analog zu Ergebnissen der Psychotherapieprozessforschung in anderen Bereichen wäre zu erwarten, dass die Art und Weise, wie betroffene Patienten am Gruppengeschehen teilnehmen, Auswirkungen auf das Erreichen der Behandlungsziele hat. Dies kann mithilfe eines neuen Untersuchungsinstruments, dem "Teilnahmequalitätsbogen" (TQB), evaluiert werden.

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Insight, psychopathology and global functioning in schizophrenia in urban Malawi

Cited by 16 publications

References 12 publications

Insight, Global Functioning and Psychopathology Amongst In-patient Clients with Schizophrenia

Insight, Global Functioning and Psychopathology Amongst In-patient Clients with Schizophrenia

Assessment of Functioning among Nigerians with Schizophrenia in a Tertiary Health Facility: Influence of Psychopathology, Socio-demographic and Treatment Factors

Partizipationsverhalten schizophren erkrankter Patienten in Psychoedukationsgruppen

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