Depression in schizophrenia: the influence of the different dimensions of insight.

David Misdrahi, Sophie Denard, Joel Swendsen, Isabelle Jaussent, Philippe Courtet
Psychiatry Research. 2014-04-01; 216(1): 12-16
DOI: 10.1016/j.psychres.2014.01.039

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1. Psychiatry Res. 2014 Apr 30;216(1):12-6. doi: 10.1016/j.psychres.2014.01.039.
Epub 2014 Jan 31.

Depression in schizophrenia: the influence of the different dimensions of
insight.

Misdrahi D(1), Denard S(2), Swendsen J(3), Jaussent I(4), Courtet P(5).

Author information:
(1)Pole de Psychiatrie 347, C.H. Charles Perrens, 33076 Bordeaux cedex, France;
CNRS UMR 5287-INCIA, Université Bordeaux 2, Bordeaux, France. Electronic
address: .
(2)Pole de Psychiatrie 347, C.H. Charles Perrens, 33076 Bordeaux cedex, France.
(3)CNRS UMR 5287-INCIA, Université Bordeaux 2, Bordeaux, France.
(4)Inserm U1061, Université Montpellier 1, Montpellier, France.
(5)Inserm U1061, Université Montpellier 1, Montpellier, France; Department of
Emergency Psychiatry, CHRU Montpellier, France.

Improving insight in patients with schizophrenia appears necessary to enhance
medication adherence and clinical outcome, but in some patients acquiring
insight can paradoxically increase hopelessness, depression and suicidal
behavior. The aim of this study is to explore the association of two dimensions
of insight (cognitive and clinical) with depression, hopelessness and clinical
variables in patients with psychosis. Using a cross-sectional design, 61
remitted outpatients meeting DSM-IV criteria for schizophrenia or
schizoaffective disorders were included. Insight was assessed using the « Scale
to Assess Unawareness of Mental Disorder » (SUMD), the PANSS-item G12 and the
Beck Cognitive Insight Scale (BCIS). Overall, 41.2% of the sample had a history
of suicide attempts. Patients in the high clinical insight group had
significantly higher depression scores, higher hopelessness scores, greater
histories of suicide attempts and were more likely to have received
psychoeducation. Compared to patients with low cognitive insight, those with
high overall cognitive insight were significantly more depressed and had more
often received psychoeducation. Greater insight may have negative consequences
in terms of depressive symptoms and therefore presents a challenge to clinicians
in assessing the individual risks and benefits of strategies intended to enhance
awareness of mental disorder.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.psychres.2014.01.039
PMID: 24529815 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus