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Lack of insight as a third variable between subjective appraisal of cognitive impairment and psychotic symptoms

Published online by Cambridge University Press:  23 March 2020

R. Rossi ,
V. Santarelli ,
C. Marucci ,
D. Gianfelice  and
F. Pacitti
R. Rossi
Affiliation:
University of L’Aquila, Department of Applied Clinical Sciences and Biotechnologies DISCAB, L’Aquila, Italy
V. Santarelli
Affiliation:
University of L’Aquila, Department of Applied Clinical Sciences and Biotechnologies DISCAB, L’Aquila, Italy
C. Marucci
Affiliation:
University of L’Aquila, Department of Applied Clinical Sciences and Biotechnologies DISCAB, L’Aquila, Italy
D. Gianfelice
Affiliation:
S. Salvatore Hospital, Community Mental Health Department, L’Aquila, Italy
F. Pacitti
Affiliation:
University of L’Aquila, Department of Applied Clinical Sciences and Biotechnologies DISCAB, L’Aquila, Italy

Abstract

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Background

The relationship between subjective appraisal of cognitive deficits and symptom severity in schizophrenia is unclear. Insight reportedly impacts on both factors. Our aim is to further asses the relationship between the subjective perception of cognitive deficits, symptom severity and lack of Insight as a mediator variable.

Methods

A total of 109 subject diagnosed with schizophrenia. Positive and Negative Syndrome Scale (PANSS) was modelled as dependent variable; Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) was modeled as independent variable and “Lack of Insight” (LoI) PANSS Item was tested as a mediator variable. Mediation was assessed using the Sobel Mediation Test.

Results

LoI acts as a suppressor variable (i.e. it enhances the relation between the independent and dependent variable) between SSTICS and negative symptoms, while showing a mediator effect between SSTICS and depressive symptoms.

Discussion

LoI has a central role in mediating the relationship between subjective appraisal of cognitive deficits on the one hand and positive and depressed symptoms on the other. Its suppressor role between SSTICS and depression is consistent with several reports of an enhanced risk of depression in patients fully aware of their disability. Its mediator role between STICSS and positive symptoms supports the centrality of LoI as a metacognitive function whose failure may worsen psychotic symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Schizophrenia and other psychotic disorders – Part 5
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S384
Copyright
Copyright © European Psychiatric Association 2017
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