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Published on: November 21, 2013
The relationship between insight and neurological dysfunction in first-episode psychosis.
1Stanley Research Unit, Cluain Mhuire Family Centre, St John of God Adult Psychiatric Service, Dublin, Ireland.
Summary
This study found no direct link between neurological soft signs (NSS) and impaired insight in first-episode psychosis patients. Further research is needed to understand insight in psychosis.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Impaired insight is a common feature of psychosis.
- Some research suggests a biological basis for impaired insight.
- Neurological soft signs (NSS) and their neural correlates show overlap with brain regions implicated in insight deficits.
Purpose of the Study:
- To investigate the relationship between neurological soft signs (NSS) and insight in patients experiencing their first episode of psychosis.
- To determine if neurological dysfunction contributes to impaired insight in psychosis.
Main Methods:
- Correlated total and subscale scores from three insight measures and two NSS scales.
- Utilized principal component analysis to create factors for overall insight and NSS.
- Analyzed data from 241 first-episode psychosis patients.
Main Results:
- Weak correlations were found between certain NSS measures and insight, even after controlling for symptoms.
- "Softer" condensed neurological evaluation (CNE) signs correlated with overall insight and specific Birchwood insight subscales (recognition of mental illness, need for treatment).
- Total neurological evaluation scale (NES) weakly correlated with recognition of medication effects.
Conclusions:
- The study does not provide evidence for a direct link between neurological dysfunction and impaired insight in psychosis.
- The concept of insight in psychosis requires further investigation and understanding.
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