Xu LiHua, Zhang Mei, Wang ShuQin, Wei YanYan, Cui HuiRu, Qian ZhenYing, Wang YingChan, Tang XiaoChen, Hu YeGang, Tang YingYing, Zhang TianHong, Wang JiJun
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Nursing and Midwifery, Jiangsu College of Nursing, Huai'an, China.
Front Psychiatry. 2021 Nov 10;12:753130. doi: 10.3389/fpsyt.2021.753130. eCollection 2021.
This study examines whether cognitive insight is impaired in high-risk individuals with attenuated psychotic symptoms (APS) and explores the relationship between cognitive and clinical insight at different durations of untreated attenuated psychotic symptoms (DUAPS). The Structured Interview for Psychosis high-risk Syndrome (SIPS) was used to identify APS individuals. APS ( = 121) and healthy control (HC, = 87) subjects were asked to complete the Beck Cognitive Insight Scale (BCIS). Clinical insight of APS individuals was evaluated using the Schedule for Assessment of Insight (SAI). APS individuals were classified into four subgroups based on DUAPS, including 0-3, 4-6, 7-12, and >12 months. Power analysis for significant correlation was conducted using the WebPower package in R. Compared with HC subjects, APS individuals showed poorer cognitive insight, with lower scores on BCIS self-reflectiveness and composite index (BCIS self-reflectiveness minus BCIS self-certainty). Only when DUAPS was longer than 12 months did the significant positive correlation between cognitive and clinical insight obtain the power about 0.8, including the associations between self-reflectiveness and awareness of illness, self-reflectiveness and the total clinical insight, and composite index and awareness of illness. The positive associations of composite index with awareness of illness within 0-3 months DUAPS and with the total score of SAI when DUAPS > 12 months were significant but failed to obtain satisfactory power. APS individuals may have impaired cognitive insight, demonstrating lower self-reflectiveness. The correlation between cognitive and clinical insight is associated with the duration of untreated attenuated psychotic symptoms.
本研究考察了具有精神病性症状衰减（APS）的高危个体的认知洞察力是否受损，并探讨了在不同未治疗精神病性症状衰减持续时间（DUAPS）下认知洞察力与临床洞察力之间的关系。使用精神病高危综合征结构化访谈（SIPS）来识别APS个体。要求APS个体（n = 121）和健康对照（HC，n = 87）完成贝克认知洞察力量表（BCIS）。使用洞察力评估量表（SAI）评估APS个体的临床洞察力。根据DUAPS将APS个体分为四个亚组，包括0 - 3个月、4 - 6个月、7 - 12个月和>12个月。使用R语言中的WebPower软件包进行显著相关性的功效分析。与HC个体相比，APS个体表现出较差的认知洞察力，在BCIS自我反思性和综合指数（BCIS自我反思性减去BCIS自我确定性）上得分较低。只有当DUAPS超过12个月时，认知洞察力与临床洞察力之间的显著正相关才获得约0.8的功效，包括自我反思性与疾病意识之间、自我反思性与总临床洞察力之间以及综合指数与疾病意识之间的关联。DUAPS在0 - 3个月内综合指数与疾病意识以及DUAPS>12个月时与SAI总分之间的正相关显著，但未获得满意的功效。APS个体可能存在认知洞察力受损，表现为较低的自我反思性。认知洞察力与临床洞察力之间的相关性与未治疗的精神病性症状衰减持续时间有关。
