Abstract
BackgroundMany studies have highlighted the similarity of the symptoms between bipolar disorders and schizophrenia. Moreover, there are no pathognomonic symptoms that can differentiate these two disorders, and 9% of schizophrenia patients have experienced a manic syndrome in their lifetime. Insight about their symptoms and illness is very important factor for the differential diagnosis and the management in schizophrenia. To examine the relationship among the insight, the psychotic and manic symptoms, and clinical variables in patients with chronic schizophrenia.MethodsSeventy-four participants (male 44, female 30) with chronic schizophrenia in community mental health facilities have been evaluated with the Scale to assess Unawareness of Mental Disorder (SUMD), the Mood Disorder Questionnaire (MDQ), and the Brief Psychiatric Rating Scale (BPRS).ResultsThe mean number of previous admission was 3.85. Their drug adherence was favorable (6.73 day/week). Mean CGI-S score was 3.8. Thirty-five percent of subject were MDQ positive (cutoff point = 7 or more). Among SUMD, “awareness of effect of medication” showed significant negative correlation (r = -0.33) with total MDQ score not with total BPRS score. The negative correlation was more obvious in participants with negative MDQ (total MDQ score 6 or less, r = -0.31). Several MDQ items (irritability, r = -0.25; decreased sleep, r = -0.27; thought racing, r = -0.28; and easy distractibility, r = -0.40) negatively correlated with “awareness of effect of medication”. In contrast, only one item (guilt feeling, r = -0.27) of BPRS revealed this correlation. Individual items in MDQ and BPRS rarely correlated with each other. Total MDQ score was not correlated with duration of illness and medication adherence.DiscussionManic symptoms were frequently detected even in schizophrenia as reported in previous studies. This made it difficult to differentially diagnose the disorder using only the total MDQ score. There was possible relationship between these manic symptoms and their insight. Identifying manic symptoms in schizophrenia would be considerable in clinical setting.
Highlights
Paranoia is unsubstantiated thinking that others want to cause harm, and it exists on a spectrum ranging from suspicion to delusions both in the general population and in individuals with psychosis (Freeman et al, 2011; Freeman, 2016)
Paranoia is interpersonal in nature, and research has shown that individuals with paranoid delusions use person attributions more than depressed or healthy controls during a task with interpersonal vignettes (Bentall, Kaney, & Dewey, 1991)
The current study will examine how paranoia correlates with neighborhood characteristics, loneliness, perceived rejection, and social network size in a transdiagnostic sample with psychosis
Summary
The result in the present study showed that patients with low function who overestimate their function have less or the same level of symptoms as patients in the two groups with ordinary functioning. In further studies it is important to investigate if this is a result of lower symptom level or if it is due to the impaired insight. This is important since the result in the present study mirror previous results where patients who overestimate a low function by clinicians, will be perceived as patients with a higher capacity and less difficulties. IMPACT OF NEIGHBORHOOD CHARACTERISTICS ON PARANOIA, LONELINESS, AND PERCEIVED REJECTION IN A TRANSDIAGNOSTIC SAMPLE WITH PSYCHOSIS. Christina Savage*,1, Cristina Garcia, LeeAnn Shan, Alexandra Andrea, Melanie Bennett, Jack Blanchard1 1University of Maryland; 2University of Maryland School of Medicine
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