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Comparison of insight among schizophrenia and bipolar disorder patients in remission of affective and positive symptoms: Analysis and critique

Published online by Cambridge University Press:  11 May 2011

Y. Braw ,
R. Sitman ,
T. Sela ,
G. Erez ,
Y. Bloch  and
Y. Levkovitz
Y. Braw
Affiliation:
Department of Behavioral Sciences, Ariel University Center of Samaria, Ariel, Israel The Emotion-Cognition Research Center, Shalvata Mental Health Care Center (affiliated with the Sackler Faculty of Medicine, Tel-Aviv University), Hod-Hasharon, Israel
R. Sitman
Affiliation:
The Emotion-Cognition Research Center, Shalvata Mental Health Care Center (affiliated with the Sackler Faculty of Medicine, Tel-Aviv University), Hod-Hasharon, Israel
T. Sela
Affiliation:
Department of Psychology and the Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
G. Erez
Affiliation:
The Emotion-Cognition Research Center, Shalvata Mental Health Care Center (affiliated with the Sackler Faculty of Medicine, Tel-Aviv University), Hod-Hasharon, Israel
Y. Bloch
Affiliation:
The Emotion-Cognition Research Center, Shalvata Mental Health Care Center (affiliated with the Sackler Faculty of Medicine, Tel-Aviv University), Hod-Hasharon, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Y. Levkovitz*
Affiliation:
The Emotion-Cognition Research Center, Shalvata Mental Health Care Center (affiliated with the Sackler Faculty of Medicine, Tel-Aviv University), Hod-Hasharon, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
*
*Corresponding author. Tel.: +972 9 7478644; fax: +972 9 7478643. E-mail address:ylevk@clalit.org.il (Y. Levkovitz).
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Abstract

Background

Schizophrenia and bipolar disorder are associated with impairments in insight, leading to a poorer clinical outcome and functioning. Earlier studies comparing the two disorders on the basis of insight included inpatients or patients who were clinically symptomatic. The current study therefore assessed patients in remission of affective symptoms and positive symptoms of schizophrenia.

Methods

Schizophrenia and bipolar disorder patients (n = 32, n = 34; respectively) underwent clinical and functional evaluations. Insight was assessed using the Scale to assess Unawareness of Mental Disorder (SUMD) and the Positive and Negative Syndrome Scale (PANSS). Attention was assessed using a continuous performance task (CANTAB's Rapid Visual Information Processing).

Results

Schizophrenia patients displayed poorer insight into having a mental disorder and into the social consequences thereof compared to the bipolar disorder patients. They were also less aware of their anhedonia-asociality. Age, however, was significantly correlated with insight and differences in insight between the patient groups became nonsignificant when age was used as a covariate in the statistical analyses. Age was not a moderating variable of the relationship between diagnosis and insight.

Conclusions

Significant differences in insight held by the two patient groups might be related to age disparities between patient groups. Earlier studies did not adequately address these age differences, their cause and their potential effects on findings. These issues are explored with regard to the findings of the current study, as well as earlier studies, emphasizing the need for further research of the relationship between age and insight.

Keywords

Schizophrenia and psychosisBipolar disorder and maniaEpidemiologyInsightIllness awareness
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 8 , November 2012 , pp. 612 - 618
Copyright
Copyright © European Psychiatric Association 2012

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