Decreased insight, but not self-stigma or belief about medicine, is associated with greater severity of delusions in a sample of long-stay patients with schizophrenia: a cross-sectional study.

Journal: BMC psychiatry

Volume: 23

Issue: 1

Year of Publication: 2023

Affiliated Institutions:  Faculty of Sciences, Lebanese University, Fanar, Lebanon. Research and Psychiatry Departments, Psychiatric Hospital of the Cross, P.O. Box , Jall-Eddib, Lebanon. Chadia_@hotmail.com. The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, , Tunisia. Research and Psychiatry Departments, Psychiatric Hospital of the Cross, P.O. Box , Jall-Eddib, Lebanon.

Abstract summary 

There are, to date, limited and inconsistent findings concerning the relationship between insight and psychotic symptoms, despite some evidence in favor of the clinical and therapeutic relevance of the insight construct. We aimed to add to the pool of the available data in this area, by examining the correlations between the severity of insight and positive psychotic symptoms (delusions and auditory hallucinations), while accounting for self-stigma and attitudes towards medication, in a sample of long-stay inpatients with schizophrenia.A cross-sectional study was conducted at the Psychiatric Hospital of the Cross, between July and October 2021. A total of 82 patients diagnosed with schizophrenia (aged 55.55 ± 10.21 years, 54.9% males) were enrolled. The semi-structured psychotic symptom rating scales, the Birchwood Insight Scale, the Belief About Medicine Questionnaire, and the Internalized Stigma of Mental Illness were used.The mean duration of illness in years was 30.15 ± 11.73, and the mean duration of hospitalization in years was 17.56 ± 9.24. Sixteen out of the 82 patients (19.5%) were considered as having poor insight. Bivariate analyses showed that higher chlorpromazine equivalent dose was significantly associated with more delusions, whereas higher insight was significantly associated with lower delusions. Multivariable analyses revealed that Higher chlorpromazine equivalent dose (Beta = 0.004) was significantly associated with more delusions, whereas higher insight (Beta = - 0.89) was significantly associated with less delusions. No significant associations were found between insight, self-stigma and hallucinations.Our results imply that more impaired insight is associated with greater severity of delusions, above and beyond the effects of self-stigma and medication doses. These findings are valuable to aid clinicians and researchers improve their understanding of the relationship insight-psychotic symptoms, and could help personalize prevention and early intervention strategies in schizophrenia.

Authors & Co-authors:  Beainy Christina C Haddad Chadia C Fekih-Romdhane Feten F Hallit Souheil S Haddad Georges G

Study Outcome 

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Citations :  David AS. Insight and psychosis: the next 30 years. Br J Psychiatry. 2020;217(3):521–3. doi: 10.1192/bjp.2019.217.
Authors :  5
Identifiers
Doi : 222
SSN : 1471-244X
Study Population
Male
Mesh Terms
Male
Other Terms
Attitudes towards medication;Auditory hallucinations;Delusions;Insight;Schizophrenia;Self-stigma
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England