Simon Andor E, Berger Gregor E, Giacomini Véronique, Ferrero François, Mohr Sylvia
Psychiatric Outpatient Services, Specialised Programme for Early Psychosis, Bruderholz, Switzerland.
Cogn Neuropsychiatry. 2006 Sep;11(5):437-51. doi: 10.1080/13546800444000308.
We investigated the relationship of insight with executive functions and symptoms in a group of stabilised inpatients with schizophrenia.
Executive functions using an extensive battery constituted of several tests as well as psychopathology were assessed in 38 inpatients with a DSM-IV diagnosis of schizophrenia. Insight was assessed with the Scale to assess Unawareness of Mental Disorder (SUMD).
A principal component analysis of the insight dimensions revealed a three-factor model which accounted for 98% of the variance. Of particular interest is the finding that a composite factor that accounted for 74% of the variance covered insight dimensions that represent a higher degree of insight (awareness of mental disorder, its social consequences, and attribution of symptoms). Only an association between letter fluency and this composite factor was found, which was weakly mediated by depressive symptoms. A stepwise multiple regression analysis revealed a relationship between antipsychotic dose and awareness of medication effect. No association of illness duration and insight was found.
The findings of partial association between dimensions of insight and measures of executive function supports the growing evidence that insight is a multidimensional phenomenon. Accordingly, they emphasise that in the framework of therapeutic interventions, enhancement of higher levels of insight needs to take into account that patients suffering from schizophrenia have differential impairment in insight dimensions.
我们在一组病情稳定的精神分裂症住院患者中研究了自知力与执行功能及症状之间的关系。
对38例符合DSM - IV精神分裂症诊断标准的住院患者进行评估，使用由多项测试组成的综合测试组评估执行功能以及精神病理学情况。采用精神障碍自知力评定量表（SUMD）评估自知力。
对自知力维度进行主成分分析，得出一个三因素模型，该模型解释了98%的方差。特别值得关注的是，一个占方差74%的复合因素涵盖了代表更高自知力程度的自知力维度（对精神障碍的认识、其社会后果以及症状归因）。仅发现字母流畅性与该复合因素之间存在关联，且这种关联由抑郁症状微弱介导。逐步多元回归分析显示抗精神病药物剂量与药物疗效意识之间存在关系。未发现病程与自知力之间存在关联。
自知力维度与执行功能测量之间部分关联的研究结果支持了越来越多的证据，即自知力是一种多维现象。因此，这些结果强调，在治疗干预框架内，提高更高水平的自知力需要考虑到精神分裂症患者在自知力维度上存在不同程度的损害。
