Insight change in psychosis: relationship with neurocognition, social cognition, clinical symptoms and phase of illness

Authors

  • P. J. Quee,

    Corresponding author
    1. Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
    2. Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, the Netherlands
    • Piotr Quee, Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands. E-mail: p.j.quee@umcg.nl

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  • L. van der Meer,

    1. Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, the Netherlands
    2. Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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  • L. Krabbendam,

    1. Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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  • L. de Haan,

    1. Department of Psychiatry, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
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  • W. Cahn,

    1. Department of Psychiatry, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
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  • D. Wiersma,

    1. Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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  • N. van Beveren,

    1. Delta Center for Mental Health Care, Poortugaal, the Netherlands
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  • G. H. M. Pijnenborg,

    1. Department of Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
    2. Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands
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  • C. L. Mulder,

    1. Erasmus Medical Center & Bavo Europoort Rotterdam, Erasmus University Rotterdam, Rotterdam, the Netherlands
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  • R. Bruggeman,

    1. Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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  • A. Aleman

    1. Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
    2. Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Abstract

Objective

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.

Method

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.

Results

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.

Conclusion

Neurocognitive abilities may predict, in part, the development of insight in psychosis.

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