Associations of psychiatric symptoms and neurocognition with clinical insight in schizophrenia

Abstract

Associations of psychiatric symptoms and neurocognition with clinical insight in schizophrenia Objective: It is important to understand the etiology of impaired insight in schiophrenia in order to develop effective interventions to improve disorder awareness, treatment adherence, and recovery outcomes. The current study aims to explore the relationship of clinical domains and neurocognitive functions with different dimensions of clinical insight among patients with schizophrenia. Methods: A total of 59 patients who met the diagnostic criteria for schizophrenia according to DSM-5 were recruited in the study. All patients were receiving outpatient treatment and were in fairly stable clinical conditions as defined by the absence of hospitalizations or changes in medication within the last three months. Patients were evaluated by Positive and Negative Symptoms Scale (PANSS), Scale to Assess Unawareness of Mental Disorder (SUMD), The Wisconsin Cart Sorting Test (WCST), Stroop-Test, Auditory Consonant Trigram Test (ACT) and Trail Making Test (TMT). Results: Mean age was 41.1±10.3 years. Of the total 59 patients, 71.2% (n=42) were male and 28.8% (n=17) were female. Mean age of onset for illness was 24.6±7.6 years, mean duration of illness was 16.5±9.4 years and mean number of hospitalizations was 2.6±2.8. According to our findings, PANSS positive and general scores were predictors for SUMD-total score, PANSS general score and duration of illness were predictors for SUMD-awareness of mental illness score, PANSS positive and general scores were predictors for SUMDawareness of the need for treatment score, PANSS general score and age of onset of schizophrenia were predictors for SUMD-awareness of the social consequences of disorder score. Conclusion: This study examined clinical insight, psychopathology and various domains of neurocognitive functioning. Our results suggest that clinical insight is associated with positive and general symptoms but not with negative symptoms and neurocognitive impairment in patients with schizophrenia.