Insight Scale Research Articles

Healthy Life Awareness, Blood Pressure Awareness and Insight Among Adult Individuals: A Population-Based Cross-Sectional Study.

To measure healthy life awareness, blood pressure awareness and insight levels, along with their predisposing factors among adult individuals. A population-based cross-sectional study. The population consisted of adult individuals in a rural district of a city in Türkiye. Voluntary individuals who visited the population screening, organized as the May Measurement Month activity, were invited to the study (n=290). The data were collected by a questionnaire, the Healthy Life Awareness Scale (HeLAS), and the Blood Pressure Awareness and Insight Scale (BASIS). Descriptive statistics, Pearson Correlation, and multiple linear regression were used to analyze the data. The mean scores of the HeLAS and the BASIS were 49.62±8.30 and 2.89±1.43, respectively. Income level, regular physical activity habits, and formerly being diagnosed with hypertension were positively associated with ahealthy life awareness level. Former diagnosis of hypertension, regular medication usage, and being unemployed were the significant predisposing factors of blood pressure awareness and insight level. Most adult individuals displayed a moderate level of healthy life awareness and a low level of blood pressure awareness and insight. Nurses could take on the leading role in developing healthy lifestyle habits among individuals, ensure medication treatment adherence, and prevent hypertension prevalence.

Predictors Affecting the Attitude Towards Homosexuality Among Health Sciences University Students in East Coast Malaysia

Introduction As a minority group homosexuality poses the risk of various mental illnesses and medical comorbidities. In Malaysia, homosexuality is prohibited according to culture, law, and religion. Thus, this group is reluctant to seek help due to the negative attitude of certain healthcare professionals. Healthcare professionals’ negative attitudes towards this group may negatively impact patient care quality. This study aimed to identify predictors of health sciences students’ attitudes toward homosexuality. Materials and methods An online cross-sectional study was conducted among 307 undergraduate clinical students at a university on the east coast of Malaysia from December 2020 to February 2021. The instruments consisted of the Homosexual Attitude Scale Malay Version (HASMV), Self-Reflection and Insight Scale (SRIS), and Duke University Religion Index (DUREL). Results The mean (SD) age of participants was 22.91 (0.78) years old. The majority are female, Malay, and Muslim. Mean (SD) scores of attitudes towards homosexuality among health sciences students were 61.53 (17.06). Non-Muslims, final-year students, and those with higher self-reflection scores in central and southern Peninsular Malaysia displayed a more positive attitude towards homosexuality, as did students with a history of contact with homosexuals. Students with higher intrinsic religiosity scores were shown to be more negative towards homosexuality. Conclusion The attitude towards homosexuality of Malaysian future health practitioners leaned mostly towards the positive attitude towards homosexuality. These findings shall aid the relevant authorities in revising the curriculum to raise awareness about homosexual health, as well as arranging training programs. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1120-1128

The paths of career aspiration for intern nursing students: A fuzzy-set qualitative comparative analysis

AimThis study was conducted to explore the combination of different conditional variables that led to high career aspiration of intern nursing students. BackgroundA severe shortage of nurses exists nationwide, and nurses’ low career aspiration contribute to high turnover rates and hinder the high-quality development of the nursing field. Nursing students undergoing clinical practice will become the backbone of future nursing staff. Enhancing their career aspiration is crucial for developing nursing career education and stabilizing the nursing team. DesignThis was a cross-sectional study. Using the cluster sampling method, 521 intern nursing students from Henan and Anhui in China were selected as participants from December 2023 to January 2024. MethodsThis study employed the fuzzy-set qualitative comparative analysis (fsQCA) to explore the configuration for paths of leading to high career aspiration among intern nursing students. General information questionnaires, career aspiration scale, clinical practice maladjustment scale, self-reflection and insight scale were used as measures in this study. ResultsThe results showed that students’ origin, professional attitude, GPA, self-reflection and insight, relationship with preceptors and clinical practice maladjustment have a combined effect on career aspiration. This study found that eight configuration combined into four models could explain 75.9 % of high-level career aspiration (solution consistency = 0.786; solution coverage = 0.759). ConclusionThe level of career aspiration among intern nursing students is the result of the combination of different conditional variables. Using a configurational perspective to intervene in nursing students with various characteristics is expected to enhance the career aspiration of intern nursing students.

The relationship between insight and coping attitudes in bipolar disorder patients

ABSTRACT Bipolar disorder is thought to determine the insights and coping attitudes that affect a patient’s compliance with treatment, which can positively affect the prognosis of the disease. This study aimed to investigate the relationship between insight and coping attitudes in bipolar disorder patients. This descriptive study was carried out with 127 volunteer patients who were diagnosed with bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and who were in a euthymic state. The Personal Information Form, Beck Cognitive Insight Scale (BCIS) and Scale of Coping Attitudes (COPE) were used as data collection tools. We found positive correlations between the total COPE score, the total BCIS score and the self-reflectivity subscale score of the BCIS. A positive and significant correlation was also determined between the BCIS subscales and total scores and coping attitudes toward adaptation with the COPE subscales (p < 0.05). A positive and significant relationship was found between the insight scores and total coping scores of the patients and their coping attitudes toward adaptation. We found that when patients’ levels of insight increased, their coping attitudes toward adaptation were used more frequently. This study revealed that individuals with high self-reflectivity can cope more effectively with the situations they face.

Nicotine Use Awareness and Nicotine Insight Scale in Addicts: A Turkish Validity–Reliability Study

Nicotine Use Awareness and Nicotine Insight Scale in Addicts: A Turkish Validity–Reliability Study

Association between cognitive insight and anxiety among community-dwelling schizophrenia patients: the chain mediating effects of family cohesion and chronotype.

To investigate the effect of cognitive insight on anxiety in community-dwelling schizophrenia patients and to construct a chain mediating model to determine the underlying mechanisms of the relationship between cognitive insight and anxiety through family cohesion and chronotype. The Beck Cognitive Insight Scale, the Chinese version of the Family Adaptability and Cohesion Scale, the Morningness-Eveningness Scale, and the Generalized Anxiety Disorder Scale were used to assess cognitive insight, family cohesion, chronotype, and anxiety in a sample of 785 individuals with schizophrenia living in the community. Spearman correlation analysis, multiple linear regression and Bootstrap methods were employed to analyze the four variables. Residential region, current employment status, and family economic status impacted anxiety among community-dwelling schizophrenia patients. All variables were associated with each other, but self-certainty was not significantly associated with anxiety. Cognitive insight and self-reflection had direct effects on anxiety, as well as indirect effects on anxiety through the partial mediating effect of chronotype, the suppressing effect of family cohesion, and the chain mediating effect of family cohesion and chronotype. Family cohesion and chronotype can mediate the relationship between cognitive insight and anxiety. Improving family functioning, promoting emotional relationships within families, and correcting non-circadian sleep patterns can reduce anxiety in community-dwelling schizophrenia patients, with important implications for improving adverse mental health outcomes.

Neurocognitive, Clinical and Reelin Activity in Rehabilitation Using Neurofeedback Therapy in Patients with Schizophrenia.

Introduction: Reelin is a neuropeptide responsible for the migration and positioning of pyramidal neurons, interneurons, and Purkinje cells. In adulthood, it still supports neuroplasticity, especially dendritic spines formation and glutamatergic neurotransmission. Genetic studies have confirmed the involvement of reelin system failure in the etiopathogenesis of mental diseases, including schizophrenia. Given the role of reelin in brain cytoarchitectonics and the regularly observed reduction in its activity in prefrontal areas in cases of schizophrenia, dysfunction of the reelin pathway fits the neurodevelopmental hypothesis of schizophrenia, both as a biochemical predisposition and/or the ultimate trigger of psychosis and as a biosocial factor determining the clinical course, and finally, as a potential target for disease monitoring and treatment. Aim: The purpose of this study was to examine associations of the reelin blood level with clinical and neurocognitive parameters during an intensive, structured neurofeedback therapy of patients with schizophrenia. Methods: Thirty-seven male patients with paranoid schizophrenia were randomly divided into two groups: a group with 3-month neurofeedback as an add-on to ongoing antipsychotic treatment (NF, N18), and a control group with standard social support and antipsychotic treatment (CON, N19). The reelin serum concentration, clinical and neurocognitive tests were compared between the groups. Results: After 3-month trial (T2), the reelin serum level increased in the NF group vs. the CON group. The negative and general symptoms of PANSS (Positive and Negative Syndrome Scale) were reduced significantly more in the NF group at T2, and the d2 (d2 Sustained Attention Test) and BCIS (Beck Cognitive Insight Scale) scores improved only in the NF group. The AIS scores improved more dynamically in the NF group, but not enough to differentiate them from the CON group at T2. Conclusions: The clinical and neurocognitive improvement within the 3-month NF add-on therapy trial was associated with a significant increase of reelin serum level in schizophrenia patients.

Insight and empathy in schizophrenia: Impact on quality of life and symptom severity

BackgroundQuality of life has emerged as a powerful indicator of therapeutic success. However, little research has been conducted to study potential factors that influence quality of life in persons with schizophrenia, particularly in low-income developing nations. AimThis study aimed to investigate how insight and empathy impacted the quality of life and severity of symptoms in patients. MethodsA descriptive cross-sectional research design was conducted on 168 patients with schizophrenia using the PANSS Scale, Schizophrenia Quality of Life Scale R4, the Interpersonal Reactivity Index, and the Birchwood Insight Scale. ResultsOur findings show that the mean score for quality of life was (70.9 ± 9.2), whereas the mean scores for empathy and insight were (60.8 ± 15.8) and (5.8 ± 1.9), respectively. Insight and empathy have predicted effects on QoL (adjusted r square = 0.035, sig = 0.009) and (adjusted r square = 0.012, sig = 0.027), respectively. On the other hand, the regression model also showed a substantial inverse relationship between the severity of the illness and both empathy and insight. Conclusion: The majority of the clients had poor quality of life, low insight, and low empathy. Insight and empathy play a role in anticipating the patient's perceptions of quality of life. They might affect how severe their illness is. Our findings highlight the importance of developing empathy and insight, and therapies that do so may aid patients with low quality of life.

Social media as a supporting mechanism during COVID-19 in Indonesia: A quantitative study on isolation among elders

BackgroundCOVID-19 pandemic has posed mental health challenges for people from all walks of life, including the elders in Indonesia. Due to the wide-ranging effects of this pandemic due to various phases of smart, partial, or full lockdown, people worldwide have faced serious problems particularly with their mental health. MethodsThis quantitative study analyses the experiences of the general public particularly focused on elders, those who are in isolation due to the COVID-19 protocols and limited social or physical interaction within the society. For investigating the social support mechanism among respondents, we have gathered a sample of respondents who are elders and using social media. The data reflect the opinion of respondents on elders during this pandemic. A survey was designed to gather data from elders facing mental health issues and using social media platforms to seek information in Indonesia. An online social support scale, self-awareness and insight scale were deployed to measure responses to the issue at hand. ResultsThe data show that the elders had varied conceptualisations about COVID-19 relating to the pandemic, i.e., eating habits, fear of death, strengthening religiosity in eating practices, fear of interacting with people, and interaction patterns. Elders were restricted to their places and had limited physical social interactions, thus social media platforms have played a significant role in developing online interaction among elders, to speak and discuss their matters for coping with the issues of isolation and mental health. ConclusionThe online media platform is considered a great support for elders to stay connected with families, friends, as well as with other communities. The study concludes that despite declaring the non-emergency status of COVID-19, elders have still suffered with long-term repercussions of this pandemic affecting their mental health.

The Structural Equation Modeling of the Relationship Between Insight and Crisis Management Mediated by Passive Defense: A Case Study of Isfahan Police Department, Iran

Background and objective Increasing insight, law enforcement knowledge, and using active and passive defense mechanisms have a significant role in crisis management, and many disasters can be solved with these mechanisms in the society. The current research aims to provide a structural equation modeling (SEM) of the relationship between insight and crisis management mediated by passive defense mechanism. Method This is a descriptive survey using SEM method. The study population consists of the employees of Isfahan police department (FAA) in Isfahan, Iran, who had participated in the provincial insight courses (n=240). The sample size was determined using Cochran’s formula. By using simple random sampling method, 148 eligible employees were selected, all of whom were second-level managers. The standard crisis management questionnaires of Jahanbakhsh et al. (2015), a researcher-made insight scale with 14 items, and a researcher-made questionnaire of passive defense with 30 items were used to collect data. To analyze the data and test the hypotheses, correlation test, stepwise multiple regression analysis, and SEM were used in SPSS software, version 20 and Smart PLS software, version 3. Results The findings showed that insight and its components together with passive defense had a significant relationship with crisis management. The variable of passive defense also had a significant mediating role in the relationship between insight and crisis management. Conclusion increasing insight is one of the important factors in improving the quality of crisis management along with paying attention to the dimensions and components of passive defense. One of the strengths of this study was the attention to the hidden layers of crisis management in the performance of police missions. By understanding the concept of passive defense, the relationship between insight and crisis management can be understood and it can be used to prevent and deal with internal and external threats.

Obesity awareness-insight is inversely associated with body composition and physical activity behaviour in women with obesity at the admission to a lifestyle modification program

Abstract Aim This study was conducted to examine obesity awareness-insight in relation to body composition and physical activity behaviour in women with obesity who were admitted to a lifestyle modification program. Subject and methods Eighty-two participants (age = 38.22 ± 12.49 years) were included. Body composition was assessed. The Obesity Awareness and Insight scale (OASIS), Sedentary Behavior Questionnaire (SBQ), and International Physical Activity Questionnaire–Short Form (IPAQ-SF) were applied. Results The OASIS total score was positively correlated with SBQ and body composition. OASIS “negative outcome awareness” score was negatively correlated with IPAQ-SF moderate physical activity (p &lt; 0.05 for all). OASIS total score and “illness awareness” and “awareness of need for treatment” scores were higher in Class 2 and Class 3 obese participants than in Class 1 participants. Conclusion This study demonstrated that increased obesity awareness-insight correlated with deteriorating body composition and increased sedentary behaviour among women with obesity who were admitted to a lifestyle modification program. Furthermore, awareness of obesity-related adverse outcomes revealed an inverse association with physical activity.

Social media as a supporting mechanism during COVID-19 in Indonesia: A quantitative study on isolation among elders

BackgroundCOVID-19 pandemic has posed mental health challenges for people from all walks of life, including the elders in Indonesia. Due to the wide-ranging effects of this pandemic due to various phases of smart, partial, or full lockdown, people worldwide have faced serious problems particularly with their mental health. MethodsThis quantitative study analyses the experiences of the general public particularly focused on elders, those who are in isolation due to the COVID-19 protocols and limited social or physical interaction within the society. For investigating the social support mechanism among respondents, we have gathered a sample of respondents who are elders and using social media. The data reflect the opinion of respondents on elders during this pandemic. A survey was designed to gather data from elders facing mental health issues and using social media platforms to seek information in Indonesia. An online social support scale, self-awareness and insight scale were deployed to measure responses to the issue at hand. ResultsThe data show that the elders had varied conceptualisations about COVID-19 relating to the pandemic, i.e., eating habits, fear of death, strengthening religiosity in eating practices, fear of interacting with people, and interaction patterns. Elders were restricted to their places and had limited physical social interactions, thus social media platforms have played a significant role in developing online interaction among elders, to speak and discuss their matters for coping with the issues of isolation and mental health. ConclusionThe online media platform is considered a great support for elders to stay connected with families, friends, as well as with other communities. The study concludes that despite declaring the non-emergency status of COVID-19, elders have still suffered with long-term repercussions of this pandemic affecting their mental health.

A mixed method approach to exploring feedback literacy through student self-reflection

When students enter university, they become increasingly accountable for their own learning. Feedback and self-reflection processes are an important part of this. Therefore, the primary aim of this mixed methods study is to contribute to the understanding of how feedback literacy and self-reflection can be measured, interact, and support each other in the learning process. The study uses reflective logs, self-reflection course grades, the Feedback Orientation Scale, and the Self-Reflection and Insight Scale to follow-up on engineering students during their first year at university. In general, a positive relation is observed between feedback literacy and self-reflection, as well as growth during the first year at university, as evidenced through students’ reflective logs. These findings support earlier research and echo the call to promote reflection about feedback to enhance student feedback literacy. As these observations were not supported by the measurement scales, it is suggested that if the goal is to assess actual engagement rather than students’ intentions, the scales should be used with caution.

Level of insight in Egyptian patients having obsessive compulsive disorder: a comparative study

Background and objectivesObsessive–compulsive disorder (OCD) is a chronic psychiatric disorder defined by the existence of obsessions and/or compulsive behaviors or mental acts persistently and affects around 1–3% of the population in the world. Multiple studies demonstrated the link of the insight level to how severe was OCD and existence of resistance to both medications and psychotherapy in individuals with OCD. Studying the characteristics associated with poor insight is very important for management of treatment-resistant OCD and development of new therapeutic approaches. The purpose of this work was to assess the level of the insight in Egyptian patients with OCD, identify clinical correlates that could anticipate the degree of insight, and assess the validity and reliability of brown assessment of belief scale after being translated to Arabic version.MethodsA comparative cross-sectional study of 96 individuals (male and female aged from 18 to 60) diagnosed with OCD based on the Arabic version of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). The study excluded any individuals with any coexisting neuro-psychiatric conditions and a history of major medical disease. Severity of OCD was assessed through the Arabic version of the Yale–Brown Obsessive–Compulsive Scale (YBOCS). Subsequently, participants performed the Brown Assessment of Beliefs Scale (BABS) after being translated into Arabic and assessed for reliability, validity and applicability of the translated form.ResultsPatients with OCD presented with poor insight were associated with more untreated time interval, longer disease duration and more severity that was dramatically differed (p ≤ 0.05, ≤ 0.001, ≤ 0.05 respectively). Also, there was a substantial notable correlation among BABS and YBOCS obsession, compulsion, and total score.ConclusionsThe existence of good insight in patients diagnosed with OCD was associated with lower severity and less duration of illness compared to patients with poor insight. Also, the more time waited before the intervention the worst the patient scores on the insight scale.

EVALUATION OF SUICIDAL BEHAVIOR AND DEPRESSION, INSIGHT AND DISEASE CHARACTERISTICS IN SCHIZOPHRENIA

Introduction: Suicide is a severe public health issue with high rates of morbidity and mortality. Schizophrenia also has a high suicide incidence, which is one of the main factors contributing to rising morbidity and mortality. For strategies to lower suicide rates, it is essential to understand the risk factors for suicide in people with schizophrenia. By evaluating the relationship between the risk of suicidal behavior and demographic factors, disease characteristics, depression, and insight in schizophrenia patients, in the light of literature information, this study aimed at preventing suicide in schizophrenia and set an example for future studies. Method: This study included 103 schizophrenia patients who underwent follow-up for at least 4 years in a community mental health center (CMHC). The study included patients who had the mental capacity to understand and complete the questionnaires, were not experiencing an acute psychotic attack, and gave their consent to participate. The patients were given the Three Components of Insight Scale (TCIS), Scale for Evaluation of Positive Symptoms in Schizophrenia (SAPS), Scale for Evaluation of Negative Symptoms in Schizophrenia (SANS), Calgary Depression Inventory in Schizophrenia (CDIS), and Suicide Behavior Scale (SBS). Results: 47% of patients demonstrated suicidal behavior, and 69% of patients were men. 46% of the group demonstrating suicidal behavior had severe or very severe suicidal ideation. Age and disease duration were revealed to be significant risk factors for suicidal behavior (p=0.033 and p=0.004, respectively), but gender, SBS, CDIS, SANS, SAPS, and TCIS scores had no significant effect. Age and suicidal behavior risk were found to be inversely correlated, with each unit of age increase reducing the risk of suicidal behavior by 0.929 times. The risk of suicidal behavior rises along with the duration of disease. With every one unit increase in the duration of disease, the risk of suicidal behavior increases by 1.133 times. Additionally, the group with severe-very severe suicidal ideation had significantly more severe depression scores than the group with mild-moderate (p=0.01). Discussion: More than half of the patients with schizophrenia who were followed up showed suicidal behavior, and approximately half of the group who had suicidal ideation showed severe suicidal ideation. Suicidal behavior was found to be correlated with age and duration of illness. While suicidal behavior increases age decreases and duration of illness increases.There was no significant correlation between insight, depression, gender, symptom severity and suicidal behavior in this population. In addition, depression scores were found to be statistically significantly higher in the group with severe-very severe suicidal ideation. According to the research, in individuals with schizophrenia who were being monitored, the frequency of suicidal behavior increased along with the severity of depression. Conclusion: It is crucial to identify the risk factors and protective factors for suicide in schizophrenia patients in order to develop interventions for them. Because suicidal behavior is a significant morbidity and mortality factor in schizophrenia.

Insight into Illness Among Inpatients in a National Forensic Mental Health Service: A Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)

IntroductionForensic psychiatric services serve a dual purpose: treatment of mental disorders and prevention of associated violent reoffending. Progression along the secure care pathway is often impeded by impaired insight, mainly as a result of treatment-resistant psychoses.ObjectivesWe assessed levels of insight among patients in Ireland’s National Forensic Mental Health Service before and after its relocation from the historic 1850 campus in Dundrum to a modern facility in Portrane, Dublin.MethodsThe VAGUS insight scale was used in this repeated measures study before and after the relocation at two time points 42 months apart. All inpatients were invited to participate in completing the self-report (VAGUS-SR) and clinician-rated (VAGUS-CR) versions on both occasions. Total scores of both versions were averaged to obtain a combined VAGUS insight score. Corresponding Positive and Negative Syndrome Scale (PANSS) scores were used to ascertain correlations between the insight and symptomatology scales. This study is part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)Results40 pairs of observations were available for legal capacity to consent to medication, combined VAGUS-CR and VAGUS-SR assessments of insight (Cronbach’s alpha=0.927), and PANSS. VAGUS-CR insight and PANSS scores were progressively better from admission and high dependency wards through medium-term medium secure wards to rehabilitation and pre-discharge wards. Mean scores did not change significantly over this time interval. Those legally certified fit to give or withhold consent by their treating consultant psychiatrists scored significantly better on the VAGUS combined insight scale: 8.3 (SD 1.7) v 5.3 (2.2) at baseline, paired t=25.9, p&lt;0.001; and also 42 months later: 8.2 (1.4) v 5.7 (3.9), paired t=5.2, p=0.022. PANSS subscales were all significantly better for those assessed as being capacitous. Change in combined VAGUS score correlated with change in all PANSS subscales. Binary logistic regression with legal capacity as the dependent variable yielded a model in which combined VAGUS score and PANSS positive symptom score were independent determinants of assessed capacity status. Receiver operating characteristic area under the curve was 0.873, 95% CI 0.760-0.986, at baseline and 0.856, 95% CI 0.720-0.991, at 42 months. A score of 7.3 yielded a sensitivity of 0.8 and a specificity of 0.8.ConclusionsThe combined VAGUS score is a reliable and valid measure of insight relevant to functional mental capacity to consent to treatment with sensitivity and specificity sufficient to guide but not bind clinical decision-making. It measures a quality that varies with symptom severity but is also partly independent of symptom severity; the constructive inclusion of self-reported insight is notable.Disclosure of InterestNone Declared

Awareness of the disease and attitude to treatment in patients with various mental disorders at the initial stages of the disease

IntroductionAn important aspect in providing effective psychiatric care and treatment is the formation of an adequate perception of their mental disorder in patients and awareness of the need for treatment, especially at the initial stages of the disease. Patients’ misunderstanding of their own psychopathological manifestations can act as a serious obstacle to their compliance and lead to an increase in the frequency of exacerbations and repeated hospitalizations.ObjectivesTo assess the attitude to the disease and treatment in patients with various mental disorders at the initial stages of the disease.MethodsClinical and psychopathological, psychological, statistical. The following scales were used: Drug Attitude Inventory (DAI, Hogan T.P. et al., 1983); Insight Scale for Psychosis (ISP, Birchwood M., 1994); Questionnaire “Style of self-regulation of behavior” (SSPM, V.I. Morosanova, 1988) and others. 17 patients with a diagnosis of bipolar disorder (BD, F31.xxx, ICD-10) were examined, the average age of patients was 25.52±4.55 years and 39 patients with a diagnosis of schizophrenia (F20.1xx and F23.1xx, ICD-10), the average age of patients was 29.29±9.71. The duration of the disorder in both groups of patients was 0.5-3 years.ResultsA comparative analysis of the average scores of the scale of attitude to the disease revealed significant differences in the groups (p≤0.01). Patients with schizophrenia had a lower awareness of their disease (2.31±0.91 points) than patients with bipolar disorder (3.59±0.76 points). Correlation analysis revealed reliable connections (p≤0.01) between the scales of attitude to the disease and drugs and the self-regulation questionnaire. In patients with schizophrenia, deeper violations were found in the links of self-regulation, such as programming and planning when assessing the presence of a mental disorder and deterioration of their condition due to discontinuation of medication (r=0.38 and r=0.36, respectively). The low level of self-regulation in general and the rigidity of negative attitudes in awareness of the disease and the need for treatment also have a negative impact on compliance with the medication regimen. No such correlations were found in patients with bipolar disorder: they were more aware of the presence of a mental disorder and the need for treatment, but the degree of compliance with the medication regimen was not high enough.ConclusionsThe treatment of patients with mental disorders requires an integrated approach with the mandatory inclusion of a psychoeducational component in order to form an adequate model of their disease and an understanding of the expected risks when therapy is discontinued. Psychoeducation is especially relevant in the early stages of the disease, both for patients with schizophrenia and with BD.Disclosure of InterestNone Declared

Treatment adherence and insight in schizophrenia spectrum disorders

IntroductionLack of adherence to antipsychotic medication in patients with schizophrenia spectrum disorders is a major risk factor for relapse and rehospitalizations which contributes to major social and economic consequences. A high proportion of patients with schizophrenia are partially or completely unaware of their mental disorder.ObjectivesThe aim of this study was to investigate the association between insight and medication adherence.MethodsA total number of 30 outpatients with schizophrenia spectrum disorders ,according to (DSM-V) diagnostic criteria who were attending the department of psychiatry A Razi hospital between august and September 30, 2023 were included in this study. Patients’ insight was measured by the birchwood insight scale. The degree of medication adherence was measured by using Medication Adherence Rating Scale (MARS).ResultsPatients enrolled in the study had a mean (SD) age of 43.2 .There was no significant correlation between patients’ insight and patients’ ages, duration of illness and hospitalization times. In addition, there was no significant association between medication adherence and age, duration of illness, number of hospitalization or social level. Impaired insight was associated with poor antipsychotic medication adherence in patients with schizophrenia spectrum disorders .Higher insight was correlated to higher therapeutic adherence. Our results showed that the level of insight and compliance to treatment are positively correlated.Conclusions The results of this study support the hypothesis that insight and treatment adherence are closely related. Interventions to enhance insight may be helpful in improving medication adherence.Disclosure of InterestNone Declared

Self-stigma and its reduction in patients with bipolar affective disorder

IntroductionThe phenomenon of self-stigma in patients with bipolar affective disorder (BD) has been studied much less than in other mental disorders (Favre, Richard-Lepourie, 2023). However, self-stigma has equally negative psychosocial consequences for them (Shargh et al, 2015). Therefore, identifying the clinical and psychological characteristics of self-stigma in BD patients, especially in the initial stages of the disease, and developing on this basis new directions for their psychosocial rehabilitation to reduce self-stigma is relevant.ObjectivesTo identify clinical and psychological characteristics of self-stigma in BD patients, to identify targets for psychosocial rehabilitation.Methods«Questionnaire for assessing the phenomenon of self-stigmatization of mentally ill people» (Mikhailova et al., 2005), «Insight Scale for Psychosis» - ISP (Birchwood et al., 1994). We examined 17 patients (12 women and 5 men) with a diagnosis of bipolar affective disorder (F31.xxx according to ICD-10). The average age of the patients was 25.52±4.55 years. The duration of the disorder is 0.5-3 years.ResultsIt was shown, that patients with BD had a high level of self-stigma. Indicator «General level of self-stigma» was 1.22±0.73 points, that higher its average values. The main component in the structure of self-stigmatization was an overestimation of possible limitations of one’s own internal activity and self-realization (1.96 ± 0.87 and 1.62 ± 0.82 points, respectively) associated with the disease. Idealization of one’s pre-illness qualities and achievements (1.62±0.82 points) and the formation of misconceptions about the loss of previous opportunities will able to lead to negative personal changes and limit the activity of patients. Correlation analysis revealed significant (p≤0.01) correlations between the «Patient’s ability to recognize painful phenomena as symptoms of mental illness» scale of the ISP scale and individual parameters of the questionnaire for assessing self-stigma: «Imagination of one’s own failure due to illness» - r = 0, 52; «Fear of becoming insolvent due to illness» - r=0.54; «Idealization of the «healthy self», r=0.51. Thus, in BD patients, self-stigma is associated with low awareness of the disease and misconceptions about it and about themselves.ConclusionsPsychoeducation programs, aimed at formation an adequate perception of mental disorder, the ability to recognize its symptoms, and destigmatization trainings to increase the social activity are needed for BD patients. Such trainings were developed during the research and are currently being tested.Disclosure of InterestNone Declared

Self-Stigma in Patients with Endogenous Mental Disorders: A Cross-Sectional Comparative Study.

Self-stigma remains one of the most vexing issues in psychiatry. It complicates the treatment and social functioning of patients with endogenous psychiatric disorders. Identifying the specific features of self-stigma depending on the type and duration of the endogenous mental illness can help solve this problem. The aim of this study was to establish the level and specific features of self-stigma in patients with various types of chronic endogenous psychiatric disorders at different disease stages and to establish the correlation between the level of self-stigma and the attitude of the patient to his/her disease and treatment. Clinical psychopathology assessment, psychometric scales and questionnaires: "Positive and Negative Syndrome Scale" (PANSS), "Questionnaire for Self-Stigma Assessment in Mentally Ill Patients", and Russian versions of the "Insight Scale for Psychosis" (ISP), and "Drug Attitude Inventory" (DAI-10). The cross-sectional study included 86 patients with endogenous mental illnesses (bipolar affective disorder and schizophrenia spectrum disorders. The analysis of the results of the "Questionnaire for Self-Stigma Assessment in Mentally Ill Patients" showed that at the initial disease stages the highest level of self-stigma is observed in patients with bipolar affective disorder (M±σ=1.22±0.73; Me [Q1; Q3]=1.10 [0.83; 1.60]), while the lowest level was observed in patients with schizophrenia spectrum disorders (M±σ=0.86±0.53; Me [Q1; Q3]=0.77 [0.31; 1.25]). Patients with schizophrenia and schizoaffective disorder and a disease duration more than five years participating in a long-term comprehensive psychosocial rehabilitation program also demonstrated high rates of self-stigma (M±σ=1.20±0.57, Me [Q1; Q3]=1.26 [0.89; 1.47]). The study groups showed differences in terms of the structure of components of self-stigma and their severity; significant correlations were uncovered between the self-stigma parameters and the attitude of patients to their disease and therapy. The results of this study contribute to a better understanding of the specific features of self-stigma in patients with various endogenous disorders at different stages of the disease. These data can be used as part of a comprehensive psychosocial treatment program for this patient cohort, as well as for future research.