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Insight in first-admission psychotic patients
S Fennig1, E Everett, E J Bromet
1Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook 11794-8790, USA.
Background:
The prevalence of insight was examined longitudinally in psychotic patients with schizophrenia (n = 86), bipolar disorder (n = 52), major depressive disorder (n = 35) and other psychoses (n = 16).
Method:
Before discharge and at 6-month follow-up, insight in first-admission patients from 10 facilities in Suffolk County, New York was rated as part of a modified Hamilton Depression Scale.
Results:
Initially, 80% of depressives but approximately half with other diagnoses manifested insight. At follow-up, most patients demonstrated insight except for the schizophrenic patients. After controlling for diagnosis, significant correlates of baseline insight were being married, hospitalized in a community or academic facility, intelligence and negative symptoms. At follow-up, after controlling for diagnosis and baseline insight, prior treatment was predictive. This finding held for schizophrenic patients separately.
Conclusion:
Lack of insight is more prevalent in schizophrenia and improves over time. The components of prior treatment leading to better insight should be explored.