Tags

Type your tag names separated by a space and hit enter

Insight: demographic differences and associations with one-year outcome in schizophrenia and schizoaffective disorder.
Clin Schizophr Relat Psychoses. 2010 Oct; 4(3):169-75.CS

Abstract

BACKGROUND

Insight is increasingly seen as an important variable for study in psychotic illness, particularly in relation to treatment adherence. This study aims to quantify the association of insight with outcome, sociodemographic variables and diagnosis in a large stable patient sample.

METHOD

Data are from a one-year, open-label, international, multicenter trial (n=670) of long-acting risperidone in adult symptomatically stable patients with schizophrenia or schizoaffective disorder. Psychopathology and insight were quantified using the Positive and Negative Syndrome Scale (PANSS). Patients were assessed at four time points over the year of the study.

RESULTS

31.2% of the sample showed clinically significant deficits in insight at baseline. There were no differences based on sex, but significant differences in age and diagnosis, with oldest patients and schizophrenia patients (cf., schizoaffective disorder) showing more deficits. Baseline insight impairment was correlated with change in PANSS score at one year (r=-0.243, p<0.001). Recursive partitioning showed that, of those whose symptoms improved, those whose insight also improved were more likely to complete the trial.

CONCLUSIONS

Insight is important above and beyond the effects of symptoms for predicting continuation in drug trials. This may have implications for the design and analysis of such trials, as well as suggesting the importance of targeting insight in treatment to increase likelihood of adherence to treatment. There also appear to be small but significant differences in insight based on age and diagnosis within the schizophrenia spectrum.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Wiffen BD
Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, UK. ben.wiffen@kcl.ac.uk
Rabinowitz J
No affiliation info available
Fleischhacker WW
No affiliation info available
David AS
No affiliation info available

MeSH

AdolescentAdultAge DistributionAgedAged, 80 and overAnalysis of VarianceAntipsychotic AgentsAttitude to HealthAwarenessCohort StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedPatient CompliancePsychiatric Status Rating ScalesPsychotic DisordersRisperidoneSchizophreniaSchizophrenic PsychologySex DistributionSocioeconomic FactorsTreatment OutcomeYoung Adult

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20880827

Citation

Wiffen, Benjamin D R., et al. "Insight: Demographic Differences and Associations With One-year Outcome in Schizophrenia and Schizoaffective Disorder." Clinical Schizophrenia & Related Psychoses, vol. 4, no. 3, 2010, pp. 169-75.
Wiffen BD, Rabinowitz J, Fleischhacker WW, et al. Insight: demographic differences and associations with one-year outcome in schizophrenia and schizoaffective disorder. Clin Schizophr Relat Psychoses. 2010;4(3):169-75.
Wiffen, B. D., Rabinowitz, J., Fleischhacker, W. W., & David, A. S. (2010). Insight: demographic differences and associations with one-year outcome in schizophrenia and schizoaffective disorder. Clinical Schizophrenia & Related Psychoses, 4(3), 169-75. https://doi.org/10.3371/CSRP.4.3.3
Wiffen BD, et al. Insight: Demographic Differences and Associations With One-year Outcome in Schizophrenia and Schizoaffective Disorder. Clin Schizophr Relat Psychoses. 2010;4(3):169-75. PubMed PMID: 20880827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insight: demographic differences and associations with one-year outcome in schizophrenia and schizoaffective disorder. AU - Wiffen,Benjamin D R, AU - Rabinowitz,Jonathan, AU - Fleischhacker,W Wolfgang, AU - David,Anthony S, PY - 2010/10/1/entrez PY - 2010/10/1/pubmed PY - 2010/12/14/medline SP - 169 EP - 75 JF - Clinical schizophrenia & related psychoses JO - Clin Schizophr Relat Psychoses VL - 4 IS - 3 N2 - BACKGROUND: Insight is increasingly seen as an important variable for study in psychotic illness, particularly in relation to treatment adherence. This study aims to quantify the association of insight with outcome, sociodemographic variables and diagnosis in a large stable patient sample. METHOD: Data are from a one-year, open-label, international, multicenter trial (n=670) of long-acting risperidone in adult symptomatically stable patients with schizophrenia or schizoaffective disorder. Psychopathology and insight were quantified using the Positive and Negative Syndrome Scale (PANSS). Patients were assessed at four time points over the year of the study. RESULTS: 31.2% of the sample showed clinically significant deficits in insight at baseline. There were no differences based on sex, but significant differences in age and diagnosis, with oldest patients and schizophrenia patients (cf., schizoaffective disorder) showing more deficits. Baseline insight impairment was correlated with change in PANSS score at one year (r=-0.243, p<0.001). Recursive partitioning showed that, of those whose symptoms improved, those whose insight also improved were more likely to complete the trial. CONCLUSIONS: Insight is important above and beyond the effects of symptoms for predicting continuation in drug trials. This may have implications for the design and analysis of such trials, as well as suggesting the importance of targeting insight in treatment to increase likelihood of adherence to treatment. There also appear to be small but significant differences in insight based on age and diagnosis within the schizophrenia spectrum. SN - 1935-1232 UR - https://www.unboundmedicine.com/medline/citation/20880827/Insight:_demographic_differences_and_associations_with_one_year_outcome_in_schizophrenia_and_schizoaffective_disorder_ L2 - http://www.diseaseinfosearch.org/result/6442 DB - PRIME DP - Unbound Medicine ER -