S48. INSIGHT VS COGNITION AND SYMPTOMATIC REMISSION AMONG PATIENTS WITH SCHIZOPHRENIA- THE INFLUENCE OF TRAIT VS STATE PHENOMENON?

Abstract

BackgroundA high ability to understand symptoms and conceptualize illness, schizophrenia, may play a central role for long-term outcome. This based on the assumption that better insight will promote increased adherence. In this work insight is defined as patients′ ability to experience symptoms and furthermore understand what causes them. Cognitive performance and symptomatic remission are analyzed to explore in what way they are contributing to the level of insight.MethodsThe study population is 294 patients with schizophrenia spectrum disorder. Two items with focus on insight, each 1 to 4 points, are used to decide level of insight. The first item “Experience of symptom” and the second item “Understanding the reason for symptoms”, where 1 point representing high and 4 point low level of insight and with a total of 8 points. Patients are then divided into three groups, Good (2 points), Moderate (3 – 5 points) and Poor (6 –8 points). Cognitive domains identified to be impaired in schizophrenia are analyzed related to the three groups of insight. Symptomatic remission is compared to the total score of insight with a Mann-Whitney test and then the different categories of insight in a cross-tabulation and Chi-square test.ResultsDifferences were found in insight between patients in symptomatic remission and those who are not. This in contrast to when patients were divided into the three insights groups and compared on cognitive performance. Only working memory and neurocognitive flexibility showed significant differences to insight. However, crystalized intelligence, as an expression of over-all cognitive ability, did not.DiscussionIn conclusion, only symptomatic remission seems to be related to insight indicating more of a state than a trait phenomenon. Surprisingly could not different levels of insight be connected to differences in cognitive ability. As this is a cross-sectional study, further research are needed where insight and symptomatic remission are analyzed in longitudinal conditions. Such a study has to focus on if successful treatment promote insight or the other way around.