Unraveling interrelationships among psychopathology symptoms, cognitive domains and insight dimensions in chronic schizophrenia

Xavier, Rose Mary; Pan, Wei; Dungan, Jennifer R.; Keefe, Richard S.E.; Vorderstrasse, Allison

doi:10.1016/j.schres.2017.07.002

Cited by 13 publications

(15 citation statements)

References 38 publications

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“…The same inverse relationship has been found with regard to hallucinations, disorganization, and negative symptoms. 60 However, these associations are, on the whole, weak, meaning that other factors play an important role. The only symptom dimension that correlates positively (but again, weakly) with insight is depression.…”

Section: What Is the Time Course Of Insight And Its Relationship With Psychopathology?mentioning

confidence: 99%

The Multiple Dimensions of Insight in Schizophrenia-Spectrum Disorders

Murri

Amore

2018

Schizophrenia Bulletin

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The concept of insight is used to indicate the propensity of patients with schizophrenia and other severe mental disorders to recognize their illness and engage in treatment. Thus, insight may have notable consequences for the ill individual: Those who lack insight are at higher risk of nonadherence to treatments, negative clinical outcomes, and worse community functioning. Although insight is an intuitive concept, its essence remains difficult to capture. However, many rating scales are available to aid assessment, both for clinical and research purposes. Insight cannot be reduced to a symptom, a psychological mechanism, or a neuropsychological function. It is likely to have dynamic relationships with all these dimensions and with responses to personal events and contextual factors. In particular, social consequences of mental illness and explanatory models that are alternative to the medical model may fundamentally shape insight and treatment choice. Moreover, the cultural or individual stigmatization of mental illness may turn the acquisition of insight into a painful event and increase the risk of depression. Clinicians need to carefully evaluate and promote insight through a personalized approach to aid patient process of care and personal growth.

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Section: What Is the Time Course Of Insight And Its Relationship With Psychopathology?mentioning

confidence: 99%

The Multiple Dimensions of Insight in Schizophrenia-Spectrum Disorders

Murri

Amore

2018

Schizophrenia Bulletin

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“…Insight in schizophrenia interacts with psychopathology symptoms in a complex way. For example, poor insight seems to be particularly associated with increased severity of positive symptoms ( Vaz et al, 2002 ; Xavier et al, 2018 ). The presence of reduced insight has been considered a state characteristic that might contribute to the phenomenology of AVHs, for example, determining the meaning of AVHs ( Waters et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Add-on Fronto-Temporal Transcranial Direct Current Stimulation (tDCS) on Auditory Verbal Hallucinations, Other Psychopathological Symptoms, and Insight in Schizophrenia: A Randomized, Double-Blind, Sham-Controlled Trial

Chang

Tzeng

Chao

et al. 2018

International Journal of Neuropsychopharmacology

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BackgroundThe efficacy of fronto-temporal transcranial direct current stimulation in treating auditory verbal hallucinations and other psychopathological symptoms of schizophrenia patients has been examined in a small number of clinical trials with limited sample sizes, but the results are mixed. Fronto-temporal transcranial direct current stimulation has also been demonstrated to enhance patients’ insight into their mental illness in an open-label pilot study. The current investigation aimed to investigate the therapeutic effects of fronto-temporal transcranial direct current stimulation on the severity of auditory verbal hallucinations, other schizophrenia symptoms, and insight in a large double blind, randomized, sham-controlled trial.MethodsSixty patients with medication-refractory auditory verbal hallucinations were randomized over 2 conditions: transcranial direct current stimulation with 2-mA, twice-daily sessions for 5 consecutive days, with anodal stimulation to the left prefrontal cortex and cathodal stimulation to the left temporo-parietal junction, and sham treatment.ResultsFronto-temporal transcranial direct current stimulation failed to cause significant changes in the severity of auditory verbal hallucinations and other schizophrenia symptoms. The levels of insight into illness (effect size=0.511, P<.001) and positive symptoms (effect size=0.781, P<.001) were largely promoted by 5 days of transcranial direct current stimulation relative to sham treatment. The beneficial effects on the 2 insight dimensions remained 1 month after transcranial direct current stimulation.ConclusionsFronto-temporal transcranial direct current stimulation is not more effective for auditory verbal hallucinations and other schizophrenia symptoms than sham treatment. But the results of transcranial direct current stimulation-associated improvement in awareness of illness and positive symptoms show promise and provide a new direction for future research into insight promotion interventions in schizophrenia.

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“…After omitting it, the effect size of the remaining 89 studies was still significant ( r = 0.1696; 95% confidence interval [CI], 0.141–0.198; p < 0.001; tau = 0.069; I 2 = 29.2%). The results of sensitivity analyses showed that five relevant studies (Ng et al, 2015; Önen et al, 2013; Tulacı et al, 2018; Vohs et al, 2015; Xavier et al, 2018) were the source of heterogeneity in total higher-order cognition, social cognition, and metacognition. After removing these five studies, significant correlation was still found in total high-order cognition ( k = 34; r = 0.290; 95% CI, 0.239–0.339; tau = 0.095; p < 0.001; I 2 = 38.4%), as well as social cognition ( k = 25; r = 0.258; 95% CI, 0.202–0.313; tau = 0.084; p < 0.001; I 2 = 34%) and metacognition ( k = 16; r = 0.324; 95% CI, 0.251–0.394; tau = 0.094; p < 0.001; I 2 = 34.4%).…”

Section: Resultsmentioning

confidence: 99%

Relationships Between Multiple Dimensions of Insight and Neurocognition, Metacognition, and Social Cognition

2022

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Insight is a complex and multidimensional concept, and has a complex relationship with cognition. A meta-analysis of 102 studies of 9396 patients was conducted to determine the magnitude of the relationship between insight and neurocognition, higher-order cognition in multiple mental disorders. Insight has been found moderately related to higher-order cognition, but only weakly related to neurocognition. The different relationship has been found between the dimensions of insight and higher-order cognition. Almost none of the correlational coefficients of insight and cognitive domains were found to differ significantly among the different diagnostic groups. In conclusion, insight may be essentially related to higher-order cognition, but not to neurocognition. The orientation and expression of different dimensions of insight might be different, and the relationship of insight and cognition might not be explained by specific diagnosis.

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Unraveling interrelationships among psychopathology symptoms, cognitive domains and insight dimensions in chronic schizophrenia

Cited by 13 publications

References 38 publications

The Multiple Dimensions of Insight in Schizophrenia-Spectrum Disorders

The Multiple Dimensions of Insight in Schizophrenia-Spectrum Disorders

The Effects of Add-on Fronto-Temporal Transcranial Direct Current Stimulation (tDCS) on Auditory Verbal Hallucinations, Other Psychopathological Symptoms, and Insight in Schizophrenia: A Randomized, Double-Blind, Sham-Controlled Trial

Relationships Between Multiple Dimensions of Insight and Neurocognition, Metacognition, and Social Cognition

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