Clinical and neurocognitive correlates of insight in patients with bipolar I disorder in remission.

OBJECTIVE

The relationship between insight and neurocognition in bipolar disorder has not been clearly established.

METHOD

A neuropsychological battery assessing attention, mental control, perceptual-motor skills, executive functions, verbal fluency and abstraction, and visuo-spatial attention was administered to 50 bipolar remitted patients and 50 healthy controls. Insight was assessed with the Scale to Assess Unawareness of Mental Disorder.

RESULTS

Patients presented significantly worse neurocognitive performance. Insight was impaired in 60% of patients, and age, educational level, manic symptoms, age of disease onset, number of admissions, and performance on several neurocognitive tests correlated significantly with insight. A regression model revealed that age and Trail Making Test part B (TMT-B) performance accounted for 32% of the variance in overall illness awareness, while performance on the TMT-B alone accounted for 28% of the variance.

CONCLUSION

Impaired insight and neurocognitive dysfunction seem to be present in euthymic bipolar patients. Insight in bipolar disorder may be partially dependent on intact neurocognition.