Department of Clinical Psychology, Faculty of Psychology, Atomi University, Tokyo, Japan.
Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Neuropsychopharmacol Rep. 2023 Sep;43(3):373-381. doi: 10.1002/npr2.12356. Epub 2023 Jun 28.
Schizophrenia is a psychiatric disorder presenting a lack of insight. Although insight changes over time, longitudinal studies of insight in schizophrenia are scarce. Furthermore, most previous studies on insight and intelligence have not measured full-scale IQ and have not been able to examine the relationship between detailed dimensions of cognitive function and insight. In this study, we assessed insight at two time points and assessed dimensions of cognitive function.
A total of 163 patients with schizophrenia participated in the study. We evaluated insight at two time points to understand the patterns of change and examined the association between insight and clinical variables. Additionally, we examined the relationship between the dimensions of cognitive function and insight.
The patients were divided into three groups based on their change in insight over time: stable at a low level of insight (poor insight), stable at a high level of insight (good insight), and changed in insight over time (unstable insight). Those in the poor insight group had lower general intelligence scores than those in the good insight and unstable insight groups. Regarding cognitive function, verbal comprehension was associated with the level of insight at baseline and follow-up. Regarding psychiatric symptoms, the poor insight group exhibited more severe symptoms than the other two groups, especially regarding positive symptoms.
Our classification of patients based on changes in insight revealed that poor insight patients had impaired cognitive function, especially verbal comprehension, and more severe positive symptoms than good insight or unstable insight patients.
精神分裂症是一种表现出缺乏洞察力的精神障碍。尽管洞察力随时间而变化，但对精神分裂症患者洞察力的纵向研究却很少。此外，大多数关于洞察力和智力的先前研究并未测量全量表智商，也无法检查认知功能的详细维度与洞察力之间的关系。在这项研究中，我们在两个时间点评估了洞察力，并评估了认知功能的维度。
共有 163 名精神分裂症患者参加了这项研究。我们在两个时间点评估了洞察力，以了解变化模式，并检查了洞察力与临床变量之间的关联。此外，我们还检查了认知功能维度与洞察力之间的关系。
根据洞察力随时间的变化，患者被分为三组：洞察力稳定在低水平（差的洞察力）、洞察力稳定在高水平（好的洞察力）和洞察力随时间变化（不稳定的洞察力）。差的洞察力组的一般智力得分低于好的洞察力组和不稳定的洞察力组。关于认知功能，言语理解与基线和随访时的洞察力水平相关。关于精神症状，差的洞察力组比其他两组表现出更严重的症状，尤其是阳性症状。
我们根据洞察力的变化对患者进行分类，结果表明，差的洞察力患者的认知功能受损，尤其是言语理解，且阳性症状比好的洞察力或不稳定的洞察力患者更严重。
