Niedźwiedzka Izabela, Kühn-Dymecka Aleksandra, Wciórka Jacek
I Klinika Psychiatryczna IPiN w Warszawie.
Psychiatr Pol. 2008 Nov-Dec;42(6):943-57.
The aim of the study was to investigate the relationship between insight and cognitive function in patients diagnosed with schizophrenia. Insight into illness is a clinically important feature influencing clinical outcome and prognosis in schizophrenia. One ofthe most important and widely discussed in recent literature factors contributing to lack of insight is cognitive dysfunction, mainly that mediated by deficits in the frontal cortical systems. A number of studies, but not all, have observed correlations between unawareness in different insight dimensions and poor performance on working memory and executive function tests.
102 individuals were included to the study, the SUMD scale (Scale for Assessment of Unawareness of Mental Disorder) was used to asses the insight, and the battery of the neuropsychological test was administrated to assess cognition.
The results indicate that only some of the insight dimensions were associated with neuropsychological assessment. The research confirmed some relationship between unawareness of effects of medications and memory functions and correlations between unawareness of social consequences of illness and executive functions. Relations between other insight dimensions and neurocognition was less clear, only unawareness of negative symptoms was related to the working memory test.
Lack of insight in schizophrenia was moderately associated with cognitive functions. Unawareness of the effects of medication was related to the working memory and learning process, unawareness of social consequences of the mental disorder was related to executive functions. Unawareness of negative symptoms showed stronger associations with cognition than unawareness of positive symptoms or disorganization.
本研究旨在调查精神分裂症患者的自知力与认知功能之间的关系。疾病自知力是影响精神分裂症临床结局和预后的一项重要临床特征。近年来文献中讨论最多且最重要的导致自知力缺乏的因素之一是认知功能障碍，主要由额叶皮质系统缺陷介导。许多研究（但并非全部）观察到不同自知力维度的无自知状态与工作记忆和执行功能测试中的不佳表现之间存在相关性。
102名个体纳入本研究，使用SUMD量表（精神障碍自知力评估量表）评估自知力，并进行一系列神经心理学测试以评估认知功能。
结果表明，只有部分自知力维度与神经心理学评估相关。研究证实了药物疗效无自知状态与记忆功能之间的一些关系，以及疾病社会后果无自知状态与执行功能之间的相关性。其他自知力维度与神经认知之间的关系不太明确，只有阴性症状无自知状态与工作记忆测试相关。
精神分裂症患者的自知力缺乏与认知功能存在中度关联。药物疗效无自知状态与工作记忆及学习过程相关，精神障碍社会后果无自知状态与执行功能相关。阴性症状无自知状态与认知的关联比阳性症状或紊乱无自知状态更强。
