Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122 Milan, Italy.
Eur Psychiatry. 2012 Nov;27(8):619-24. doi: 10.1016/j.eurpsy.2011.09.002. Epub 2011 Nov 30.
To evaluate potential differences in insight among bipolar manic, mixed and bipolar depressed inpatients and assess the role of clinical and demographic characteristics as possible predictors.
One hundred and twenty consecutive inpatients divided into three diagnostic groups were studied on admission (T0), at discharge (T1) and at 18weeks after hospitalization (T2). The young mania rating scale (YMRS), the Hamilton rating scale for depression (HAMD) and the scale to assess unawareness of mental disorder (SUMD) were used.
Patients with mixed mania showed highest scores on the SUMD than patients with mania or bipolar depression. It was found a significant relationship between improvements in mania and in the insight. The level of insight at baseline was the only predictor of awareness in social consequences, moreover clinical and demographic characteristics were predictors of insight into mental illness. For what concerns insight about therapy benefits it was influenced by level of mania at baseline.
The three general dimensions of insight revealed significant differences among the three groups. Regression models suggest that insight is a multidimensional concept in which some aspects are state-related, associated with psychopathology, whereas others are trait-like qualities, not directly associated with symptoms and predicted only by level at baseline.
评估双相情感障碍躁狂、混合和抑郁住院患者之间洞察力的潜在差异，并评估临床和人口统计学特征作为可能的预测因子的作用。
120 名连续入院的患者在入院时（T0）、出院时（T1）和住院后 18 周（T2）进行了研究。使用杨氏躁狂评定量表（YMRS）、汉密尔顿抑郁评定量表（HAMD）和精神障碍自知力评定量表（SUMD）。
混合躁狂患者的 SUMD 评分高于躁狂或双相抑郁患者。发现躁狂和洞察力的改善之间存在显著关系。基线时的洞察力水平是对社会后果的认识的唯一预测因子，此外，临床和人口统计学特征是对精神疾病的洞察力的预测因子。关于治疗益处的洞察力，它受到基线时躁狂程度的影响。
洞察力的三个一般维度在三组之间存在显著差异。回归模型表明，洞察力是一个多维概念，其中一些方面与状态相关，与精神病理学有关，而另一些方面则是特质样的品质，与症状没有直接关系，仅由基线水平预测。
