Cuesta Manuel J, Peralta Victor, Zarzuela Amalia, Zandio Maria
Psychiatric Unit of Virgen del Camino Hospital, E-31008 Pamplona, Spain.
BMC Psychiatry. 2006 May 31;6:26. doi: 10.1186/1471-244X-6-26.
It has been reported that lack of insight is significantly associated with cognitive disturbance in schizophrenia. This study examines the longitudinal relationships between insight dimensions and cognitive performance in psychosis.
Participants were 75 consecutively admitted inpatients with schizophrenia, affective disorder with psychotic symptoms or schizoaffective disorder. Assessments were conducted at two time points during the study: at the time of hospital discharge after an acute psychotic episode and at a follow-up time that occurred more than 6 months after discharge. A multidimensional approach of insight was chosen and three instruments for its assessment were used: the Scale to Assess Unawareness of Mental Disorder (SUMD), three items concerning insight on the Assessment and Documentation in Psychopathology (AMDP) system and the Insight and Treatment Attitudes Questionnaire. The neuropsychological battery included a wide range of tests that assessed global cognitive function, attention, memory, and executive functions.
After conducting adequate statistical correction to avoid Type I bias, insight dimensions and cognitive performance were not found to be significantly associated at cross-sectional and longitudinal assessments. In addition, baseline cognitive performance did not explain changes in insight dimensions at follow-up. Similar results were found in the subset of patients with schizophrenia (n = 37). The possibility of a Type II error might have increased due to sample attrition at follow-up.
These results suggest that lack of insight dimensions and cognitive functioning may be unrelated phenomena in psychosis.
据报道，自知力缺乏与精神分裂症的认知障碍显著相关。本研究探讨了精神病患者自知力维度与认知表现之间的纵向关系。
研究对象为75例连续入院的精神分裂症、伴有精神病性症状的情感障碍或分裂情感性障碍患者。在研究期间的两个时间点进行评估：急性精神病发作后的出院时，以及出院后6个月以上的随访时。采用多维自知力评估方法，并使用三种评估工具：精神障碍自知力评定量表（SUMD）、精神病理学评估与记录（AMDP）系统中关于自知力的三个项目以及自知力与治疗态度问卷。神经心理测验组合包括一系列评估整体认知功能、注意力、记忆力和执行功能的测试。
在进行充分的统计校正以避免I型偏倚后，在横断面和纵向评估中，自知力维度与认知表现均未发现显著相关性。此外，基线认知表现无法解释随访时自知力维度的变化。在精神分裂症患者亚组（n = 37）中也发现了类似结果。由于随访时样本流失，可能增加了II型错误的可能性。
这些结果表明，自知力维度缺乏与认知功能在精神病中可能是不相关的现象。
