Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Asian J Psychiatr. 2018 Aug;36:112-117. doi: 10.1016/j.ajp.2018.07.001. Epub 2018 Jul 17.
To evaluate the relationship between neurocognitive deficits and insight (clinical & cognitive) among patients with schizophrenia in clinical remission.
60 patients with schizophrenia (diagnosed as per the DSM-IV criteria) in clinical remission were assessed on Beck Cognitive Insight scale (BCIS), Positive and Negative symptom scale (PANSS) and neurocognitive battery (Trail A and B, Stroop Test, Controlled Oral Words Association (COWA) and Tower of London (TOL).
Lower processing speed, low cognitive flexibility and poor executive functions as assessed by Trail A, Trail B and TOL respectively and higher verbal fluency (COWA) were associated with poor cognitive insight in the self-certainty domain. Poor executive functioning (3 moves problem of TOL) was associated with lower cognitive insight in the domain of self-reflectiveness. Clinical insight as assessed by item number 12 of general psychopathology subscale of PANSS did not have any association with any of the neurocognitive domains except for few subsets of executive functions as assessed by TOL. There was no correlation between clinical insight and cognitive insight. However, many of these correlations were weak and could be due to Type-1 error as significance of correlation was fixed at two tailed 0.05 level. Multiple regression analysis demonstrated cognitive flexibility as assessed by Trail B test and executive functions (3 moves and 5 moves problems of TOL) to be the significant predictors of self-certainty and self- reflectiveness domains of the cognitive insight.
The present study suggests that poor cognitive flexibility and executive dysfunction are associated with poor cognitive insight but the impact of poor neurocognitions on the clinical insight is not very significant.
评估精神分裂症临床缓解期患者的神经认知缺陷与洞察力（临床和认知）之间的关系。
对 60 名处于临床缓解期的精神分裂症患者（根据 DSM-IV 标准诊断）进行贝克认知洞察力量表（BCIS）、阳性和阴性症状量表（PANSS）和神经认知测验（Trail A 和 B、Stroop 测试、连续口头联想测验（COWA）和伦敦塔测验（TOL））评估。
Trail A、Trail B 和 TOL 分别评估的处理速度较慢、认知灵活性低和执行功能差，以及 COWA 言语流畅性较高，与自我确信领域的认知洞察力差相关。执行功能差（TOL 的 3 步问题）与自我反思领域的认知洞察力差相关。PANSS 一般精神病理学分量表第 12 项评估的临床洞察力与除 TOL 评估的几个执行功能子集外，与任何神经认知领域均无关联。临床洞察力与认知洞察力之间没有相关性。然而，这些相关性很多都很微弱，这可能是由于类型 1 错误所致，因为相关性的显著性固定在双侧 0.05 水平。多元回归分析表明，Trail B 测试评估的认知灵活性和执行功能（TOL 的 3 步和 5 步问题）是自我确信和自我反思认知洞察力领域的重要预测因子。
本研究表明，认知灵活性差和执行功能障碍与认知洞察力差有关，但神经认知功能障碍对临床洞察力的影响并不显著。
