Department of Psychiatry, Faculty of Medicine and Dentistry, Palacký University Olomouc, I.P.Pavlova 6, 77520, Olomouc, Czech Republic.
Psychiatr Q. 2012 Sep;83(3):293-310. doi: 10.1007/s11126-011-9200-4.
Although there has been interest in insight in bipolar disorder, research has not been as developed as in schizophrenia. The Medline, Embase, and PsychInfo data bases were searched. The key words used in the search were "bipolar", "mania", "manic", "awareness", and "insight". Books, editorials, letters, and reports on pediatric subjects were excluded. Abstracts or full texts were screened for relevance. Better insight is associated with better adherence to treatment and better outcomes. Impairments of executive functions and memory, as well as higher severity of psychotic symptoms, are associated with impairments of insight. Insight is more impaired during an illness episode than during remission, in mixed than in pure manic episodes, in bipolar II than in bipolar I patients, in pure mania than in bipolar or unipolar depression. Psychosocial treatments improve insight and outcomes. There is a need for integration of quantitative assessment methods and their introduction into research and clinical practice.
尽管人们对双相情感障碍的洞察力很感兴趣，但相关研究的发展不如精神分裂症那样成熟。我们检索了 Medline、Embase 和 PsychInfo 数据库。搜索中使用的关键词是“bipolar”、“mania”、“manic”、“awareness”和“insight”。排除了关于儿科主题的书籍、社论、信件和报告。筛选摘要或全文以确定相关性。更好的洞察力与更好地遵守治疗和更好的结果相关。执行功能和记忆的损伤，以及更严重的精神病症状，与洞察力的损伤有关。在疾病发作期间，洞察力比缓解期间更差，在混合性躁狂发作中比单纯性躁狂发作更差，在双相情感障碍 II 型患者中比在双相情感障碍 I 型患者中更差，在单纯性躁狂中比在双相情感障碍或单相抑郁中更差。心理社会治疗可改善洞察力和结果。需要整合定量评估方法，并将其引入研究和临床实践中。
