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Related Experiment Videos

Insight in first-episode psychosis.

Joseph P McEvoy1, Jackie Johnson, Diana Perkins

  • 1John Umstead Hospital, Duke University Department of Psychiatry, Butner, NC 27509, USA. jpmcevoy@duke.edu

Psychological Medicine
|June 3, 2006
PubMed
Summary

This study found that better insight in first-episode psychosis patients is linked to older age, female gender, white ethnicity, higher depression, better cognition, and larger brain volumes. Improved insight also correlated with longer medication adherence.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Investigated relationships between insight and psychopathology, cognitive performance, brain volume, and depression in first-episode psychosis (FEP).
  • 251 FEP patients were randomized to 2 years of double-blind olanzapine or haloperidol treatment.

Purpose of the Study:

  • To examine factors associated with insight in FEP.
  • To understand the longitudinal course of insight during antipsychotic treatment.
  • To determine if insight influences medication adherence and study completion.

Main Methods:

  • Insight was measured using the Insight and Treatment Attitudes Questionnaire (ITAQ) at multiple time points.
  • Psychopathology was assessed using the Positive and Negative Syndromes Scale (PANSS).

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  • Cognitive function and brain volumes were also evaluated.

    • Main Results:

    • Older age, female gender, white ethnicity, higher depression scores, better neurocognitive function, and larger brain volumes were associated with greater insight.
    • Higher psychopathology scores were linked to less insight.
    • Improved insight over time was observed, but not significantly different between treatment groups; greater insight predicted longer time to medication non-adherence.

    Conclusions:

    • Insight in FEP is multifactorial, influenced by demographic, clinical, cognitive, and neurobiological factors.
    • Patients with poor insight are at higher risk for medication non-adherence.