Donohoe Gary, Hayden Judy, McGlade Nicola, O'Gráda Cara, Burke Teresa, Barry Sandra, Behan Caragh, Dinan Timothy G, O'Callaghan Eadbhard, Gill Michael, Corvin Aiden P
Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.
J Int Neuropsychol Soc. 2009 May;15(3):471-5. doi: 10.1017/S1355617709090559.
Poor insight is associated with impaired cognitive function in psychosis. Whether poor clinical insight overlaps with other aspects of self-awareness in schizophrenia, such as cognitive self-awareness, is unclear. We investigated whether awareness of clinical state ("clinical insight") and awareness of cognitive deficits ("cognitive insight") overlap in schizophrenia in a sample of 51 stabilized patients with chronic schizophrenia. Cognitive insight was assessed in terms of the agreement between subjective self-report and neuropsychological assessment. Patients who show good cognitive insight did not necessarily show good clinical insight. By contrast, self-report and objective neuropsychological assessment only correlated for patients in the intact clinical insight group and not for those in the impairment clinical insight group. We conclude that while good cognitive insight may not be necessary for good clinical insight, good cognitive awareness is at least partly reliant on the processes involved in clinical insight.
洞察力缺失与精神病患者的认知功能受损有关。目前尚不清楚，在精神分裂症中，临床洞察力缺失是否与自我意识的其他方面（如认知自我意识）存在重叠。我们对51名病情稳定的慢性精神分裂症患者进行了调查，以研究精神分裂症患者的临床状态意识（“临床洞察力”）和认知缺陷意识（“认知洞察力”）是否存在重叠。认知洞察力通过主观自我报告与神经心理学评估之间的一致性来评估。具有良好认知洞察力的患者不一定具有良好的临床洞察力。相比之下，自我报告与客观神经心理学评估仅在临床洞察力完整组的患者中存在相关性，而在临床洞察力受损组的患者中则不存在相关性。我们得出结论，虽然良好的临床洞察力不一定需要良好的认知洞察力，但良好的认知意识至少部分依赖于临床洞察力所涉及的过程。
