Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, the Netherlands.
Acta Psychiatr Scand. 2014 Feb;129(2):126-33. doi: 10.1111/acps.12138. Epub 2013 Apr 18.
Impaired insight is an important and prevalent symptom of psychosis. It remains unclear whether cognitive disturbances hamper improvements in insight. We investigated the neurocognitive, social cognitive, and clinical correlates of changes in insight.
One hundred and fifty-four patients with a psychotic disorder were assessed at baseline (T0 ) and after three years (T3 ) with the Birchwood Insight Scale, the Positive And Negative Syndrome Scale, measures of neurocognition and social cognition. Linear regression analyses were conducted to examine to what extend neurocognition, social cognition, clinical symptoms and phase of illness could uniquely predict insight change. Subsequently, changes in these factors were related to insight change.
Better neurocognitive performance and fewer clinical symptoms at baseline explained insight improvements. The additional effect of clinical symptoms over and above the contribution of neurocognition was significant. Together, these factors explained 10% of the variance. Social cognition and phase of illness could not predict insight change. Changes in clinical symptoms, but not changes in neurocognitive performance were associated with insight change.
Neurocognitive abilities may predict, in part, the development of insight in psychosis.
洞察力受损是精神病的一个重要且普遍的症状。目前尚不清楚认知障碍是否会阻碍洞察力的改善。我们研究了洞察力变化的神经认知、社会认知和临床相关性。
154 名患有精神病的患者在基线（T0）和 3 年后（T3）分别接受了 Birchwood 洞察力量表、阳性和阴性综合征量表、神经认知和社会认知测试的评估。线性回归分析用于检验神经认知、社会认知、临床症状和疾病阶段如何能独特地预测洞察力的变化。随后，将这些因素的变化与洞察力的变化联系起来。
基线时更好的神经认知表现和更少的临床症状可以解释洞察力的改善。临床症状对神经认知的贡献有显著的额外影响。这些因素共同解释了 10%的方差。社会认知和疾病阶段不能预测洞察力的变化。临床症状的变化，而不是神经认知表现的变化与洞察力的变化有关。
神经认知能力可能部分预测精神病中洞察力的发展。
