Insight in first episode psychosis: who is measuring what?

AIMS

To compare different self-administered or clinician-rated insight scales in an FEP population.

METHODS

A self-administered measure (Beck Cognitive Insight Scale - BCIS) and clinician-rated scales (Scale of Unawareness of Mental Disorder - SUMD and Positive And Negative Symptoms Scale - PANSS-G12 insight item) were completed by 38 patients with a diagnosis of FEP.

RESULTS

The scales had good internal consistency and only the clinician-rated scales were intercorrelated (SUMD - awareness of mental disorder and PANSS-G12 items (r=0.657, P<0.001)). Moreover, we observed a significant association of SUMD and PANSS positive and general subscales and a trend association for BCIS and PANSS negative subscale.

CONCLUSION

Differential associations observed between insight and symptoms may suggest different clinical predictive values for each measure. Our results suggest the necessity to qualify the term 'insight' when discussing research results, most notably with respect to who is rating and what aspect of insight is being rated.