Abstract
BackgroundImpairment of insight is a prominent feature of schizophrenia and is associated with poor adherence and poor outcomes. While many studies have investigated the nature of insight impairment in schizophrenia, few have charted its course longitudinally. In this study we investigated changes in different components of insight during the first 12 months of antipsychotic treatment.MethodsThe sample comprised 107 never or minimally treated patients with a first episode of schizophrenia, schizophreiform or schizoaffective disorder. They were treated according to a fixed protocol with flupenthixol decanoate. Insight was assessed with the self-rating Birchwood Insight Scale and the investigator rated global insight item of the PANSS scale.Psychopathology was assessed with the PANSS and CDSS. Cognitive performance was assessed with the MATRICS. We performed evaluations at baseline, month 6 and month 12. Linear mixed effects mixed models for repeated measures were conducted to assess changes over time, adjusting for age, gender and educational status.ResultsThere were no significant changes in the BIS subscales of symptom awareness, awareness of illness or total BIS score. The need for treatment subscale improved slightly (p=0.02) while the PANSS global insight improved considerably (p<0.0001). Degree of insight impairment was only weakly correlated with psychopathology and cognitionDiscussionInsight impairment is common in schizophrenia and displays trait-like rather than state-like features. These findings have important clinical implications.
Highlights
Impairment of insight is a prominent feature of schizophrenia and is associated with poor adherence and poor outcomes
Insight was assessed with the self-rating Birchwood Insight Scale and the investigator rated global insight item of the PANSS scale.Psychopathology was assessed with the PANSS and CDSS
Degree of insight impairment was only weakly correlated with psychopathology and cognition Discussion: Insight impairment is common in schizophrenia and displays trait-like rather than state-like features
Summary
EAT and assessed correlations among the EAT and three other commonly used empathy tasks. Methods: Patients (n=92) and healthy controls (n=42) matched for age and education, completed the EAT, the Interpersonal Reactivity Index, the Questionnaire of Cognitive and Affective Empathy and the Faux Pas task. Differences between groups were analyzed and correlations were calculated between empathy measurement instruments. Results: The groups differed in EAT performance, with controls outperforming patients. Though there were group differences on the cognitive and affective empathy questionnaires (with lower scores for patients in comparison to controls), EAT performance did not correlate with questionnaire scores. Reduced empathy performance did not seem to be part of a generalized cognitive deficit, as differences between patients and controls on general cognition was not significant. The lack of correlation between the EAT and the questionnaires suggests a distinction between self-report empathy and actual empathy performance. Lebogang Phahladira*,1, Bonginkosi Chiliza, Laila Asmal, Sanja Kilian, Freda Scheffler, Robin Emsley1 1Stellenbosch University; 2University of KwaZulu Natal
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