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Insight and Psychotic Illness

Cross-sectional and Longitudinal Associations

Published online by Cambridge University Press:  02 January 2018

Anthony David ,
Jim van Os ,
Peter Jones ,
Ian Harvey ,
Alice Foerster  and
Thomas Fahy
Anthony David*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
Jim van Os
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
Peter Jones
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
Ian Harvey
Affiliation:
Coventry Mental Health Unit, Coventry
Alice Foerster
Affiliation:
Department of Psychiatry, University of Berne, Switzerland
Thomas Fahy
Affiliation:
Maudsley Hospital, Denmark Hill, London
*
Dr Anthony David, Department of Psychological Medicine, King's College Hospital, 103 Denmark Hill, London SE5 8AF
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Abstract

Background

Insight has recently re-emerged as an important aspect of psychopathology amenable to empirical study. We sought to examine the relationship between various aspects of insight into illness and clinical, sociodemographic and neuropsychological variables.

Method

From an inner-London catchment area population, 150 in-patients with recent onset of psychosis were assessed on a variety of measures, including the Present State Examination (PSE). Subjects were followed up for a mean of four years and reassessed.

Results

High IQ was associated with better insight as rated on the PSE, while gender, ethnicity and a diagnosis of schizophrenia appeared to be unrelated. At follow-up, similar associations were found, as well as correlations with attitudes to treatment and a more elaborate measure of insight. Cerebral ventricular enlargement and tests of frontal lobe function did not correlate with insight, but there was a curious, strong association with left-handedness at both assessment points. Initial insight correlated significantly but weakly with insight at follow-up.

Conclusions

The assessment of insight in psychosis has concurrent validity and is a distinct aspect of psychotic phenomenology. It may, in part, have a neuropsychological basis.

Type
Papers
Information
The British Journal of Psychiatry , Volume 167 , Issue 5 , November 1995 , pp. 621 - 628
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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