Insight in bipolar disorder through the course of manic episode and its clinical correlates

Abstract

IntroductionInsight is a well-documented phenomenon for psychotic disorders. It has been studied extensively in schizophrenia and its association with clinical outcomes has drawn increased attention. Although less is known for affective disorders, recent studies point out that impaired insight in bipolar disorder may take part in patients’ overall well-being.AimsExploring the main components of insight in psychiatry, particularly in bipolar disorder.ObjectivesWith this study, we wanted to examine how clinical and cognitive insights change in patients with bipolar disorder through their hospitalization period and how they correlate with symptom severity and neuropsychological functioning.MethodsIn this prospective study, inpatients with bipolar I disorder who were presented by manic episode with psychotic features were included. The patients were assessed with Young Mania Rating Scale, Beck Cognitive Insight Scale, Schedule for the Assessment of Insight-Expanded Version (SAI-E) and a neuropsychological test battery both at the time of admission and discharge.ResultsAs of October 2015, a total number of 20 patients with bipolar I disorder participated in the study. Preliminary results revealed a significant improvement in the total score of clinical insight, which was measured with SAI-E by the time of discharge (P = 0.001). This transition was strongly correlated with the decrease in symptom severity (P = 0.006, r = −0.61). Improved clinical insight exhibited significant correlation with the increase in patients’ memory span (P = 0.007, r = −0.596).ConclusionThe preliminary results suggest that changes in symptom severity and working memory might be the determinants of improvement in clinical insight of inpatients with bipolar disorder through manic episode.Disclosure of interestThe authors have not supplied their declaration of competing interest.