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Cognitive insight and verbal memory in first episode of psychosis

Published online by Cambridge University Press:  16 April 2020

Martin Lepage ,
Lisa Buchy ,
Michael Bodnar ,
Marie-Claude Bertrand ,
Ridha Joober  and
Ashok Malla
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Abstract

Beck and collaborators have proposed a distinction between clinical insight and cognitive insight and have developed a tool for the assessment of the latter, namely the Beck Cognitive Insight Scale (BCIS). The present study explored in 51 patients with a first episode of psychosis the neurocognitive correlates of cognitive insight as assessed with the BCIS. Global measures for seven domains of cognition including verbal learning and memory, visual learning and memory, working memory, speed of processing, reasoning and problem solving, attention, and social cognition were examined. Secondly, we examined whether two clinical insight measures, the Scale to assess Unawareness of Mental Disorder (SUMD) and the insight item from the Positive and Negative Symptoms Scale (PANSS), could produce similar or different patterns of association with neurocognitive functions as those identified with the BCIS. Correlational analyses revealed significant associations between the BCIS Composite Index and the verbal learning and memory. No significant associations were observed between any of the neurocognitive domains and the PANSS or SUMD clinical insight measures, despite high inter-correlations among the three insight measures. These results suggest that cognitive insight, but not clinical insight, may rely on memory processes whereby current experiences are appraised based on previous ones.

Keywords

InsightMemoryCognitionPsychosisSchizophreniaSchizophrenia and psychosisPsychometry and assessments in psychiatry
Type
Original article
Information
European Psychiatry , Volume 23 , Issue 5 , August 2008 , pp. 368 - 374
Copyright
Copyright © Elsevier Masson SAS 2008

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References

Achim, A.M.Lepage, M.Episodic memory-related activation in schizophrenia: meta-analysis Br J Psychiatry 187 2005 500–509.Google Scholar
Addington, D.Addington, J.Schissel, B.A depression rating scale for schizophrenics Schizophr Res 3 1990 247–251.Google Scholar
Albus, M.Hubmann, W.Scherer, J.Dreikorn, B.Hecht, S.Sobizack, N. et al A prospective 2-year follow-up study of neurocognitive functioning in patients with first-episode schizophrenia Eur Arch Psychiatry Clin Neurosci 252 2002 262–267.Google Scholar
Aleman, A.Agrawal, N.Morgan, K.D.David, A.S.Insight in psychosis and neuropsychological function: meta-analysis Br J Psychiatry 189 2006 204–212.Google Scholar
Amador, X.F.Flaum, M.Andreasen, N.C.Strauss, D.H.Yale, S.A.Clark, S.C. et al Awareness of illness in schizophrenia and schizoaffective and mood disorders Arch Gen Psychiatry 51 1994 826–836.Google Scholar
Amador, X.F.Strauss, D.H.Poor insight in schizophrenia Psychiatr Q 64 1993 305–318.Google Scholar
Amador, X.F.Strauss, D.H.Yale, S.A.Flaum, M.M.Endicott, J.Gorman, J.M.Assessment of insight in psychosis Am J Psychiatry 150 1993 873–879.Google Scholar
Andreasen, N.C.Modified scale for the assessment of negative symptoms (SANS) 1984 Iowa City: University of Iowa.Google Scholar
Andreasen, N.C.Scale for the assessment of positive symptoms (SAPS) 1984 Iowa City: University of Iowa.Google Scholar
Beck, A.T.Baruch, E.Balter, J.M.Steer, R.A.Warman, D.M.A new instrument for measuring insight: the Beck cognitive insight scale Schizophr Res 68 2004 319–329.Google Scholar
Beck, A.T.Warman, D.M.Cognitive insight: theory and assessmentAmador, X.F.David, A.S.Insight and psychosis: awareness of illness in schizophrenia and related disorders 2004 Oxford University Press.Google Scholar
Blumenfeld, R.S.Ranganath, C.Prefrontal cortex and long-term memory encoding: an integrative review of findings from neuropsychology and neuroimaging Neuroscientist 13 2007 280–291.Google Scholar
Boyer, P.Phillips, J.L.Rousseau, F.L.Ilivitsky, S.Hippocampal abnormalities and memory deficits: new evidence of a strong pathophysiological link in schizophrenia Brain Res Rev 54 2007 92–112.Google Scholar
Brinkenkamp, R.Zillmer, E.The d2 test of attention 1998 Seattle, WA: Hogrefe & Huber Publishers.Google Scholar
Buckner, R.L.Kelley, W.M.Petersen, S.E.Frontal cortex contributes to human memory formation Nat Neurosci 2 1999 311–314.Google Scholar
Corcoran, R.Mercer, G.Frith, C.D.Schizophrenia, symptomatology and social inference: investigating “theory of mind” in people with schizophrenia Schizophr Res 17 1995 5–13.Google Scholar
David, A.S.Insight and psychosis Br J Psychiatry 156 1990 798–808.CrossRefGoogle Scholar
Drake, R.J.Lewis, S.W.Insight and neurocognition in schizophrenia Schizophr Res 62 2003 165–173.Google Scholar
Engh, J.A.Friis, S.Birkenaes, A.B.Jonsdottir, H.Ringen, P.A.Ruud, T. et al Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study BMC Psychiatry 7 2007 71.Google Scholar
First, M.B.Spitzer, R.L.Gibbon, M.Williams, J.B.W.Structured clinical interview for DSM-IV patient edition (SCID-I/P V and SCID-I/NP version 2.0) 1998 New York: Biometric Research Department.Google Scholar
Flashman, L.A.McAllister, T.W.Johnson, S.C.Rick, J.H.Green, R.L.Saykin, A.J.Specific frontal lobe subregions correlated with unawareness of illness in schizophrenia: a preliminary study J Neuropsychiatry Clin Neurosci 13 2001 255–257.Google Scholar
Flashman, L.A.Roth, R.M.Neural correlates of unawareness of illness in psychosisAmador, X.F.David, A.S.Insight and psychosis: awareness of illness in schizophrenia and related disorders 2004 Oxford University Press 157–176.CrossRefGoogle Scholar
Gibbs, A.A.David, A.S.Delusion formation and insight in the context of affective disturbance Epidemiol Psichiatr Soc 12 2003 167–174.Google Scholar
Gold, S.Arndt, S.Nopoulos, P.O'Leary, D.S.Andreasen, N.C.Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia Am J Psychiatry 156 1999 1342–1348.Google Scholar
Goodman, C.Knoll, G.Isakov, V.Silver, H.Insight into illness in schizophrenia Compr Psychiatry 46 2005 284–290.Google Scholar
Hoff, A.L.Sakuma, M.Wieneke, M.Horon, R.Kushner, M.DeLisi, L.E.Longitudinal neuropsychological follow-up study of patients with first-episode schizophrenia Am J Psychiatry 156 1999 1336–1341.Google Scholar
Kay, S.R.Fiszbein, A.Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia Schizophr Bull 13 1987 261–276.Google Scholar
Koren, D.Seidman, L.J.Poyurovsky, M.Goldsmith, M.Viksman, P.Zichel, S. et al The neuropsychological basis of insight in first-episode schizophrenia: a pilot metacognitive study Schizophr Res 70 2004 195–202.Google Scholar
Lepage, M.Ghaffar, O.Nyberg, L.Tulving, E.Prefrontal cortex and episodic memory retrieval mode Proc Natl Acad Sci U S A 97 2000 506–511.CrossRefGoogle Scholar
Lysaker, P.H.Bell, M.D.Bryson, G.Kaplan, E.Neurocognitive function and insight in schizophrenia: support for an association with impairments in executive function but not with impairments in global function Acta Psychiatr Scand 97 1998 297–301.Google ScholarPubMed
Marks, K.A.Fastenau, P.S.Lysaker, P.H.Bond, G.R.Self-appraisal of illness questionnaire (SAIQ): relationship to researcher-rated insight and neuropsychological function in schizophrenia Schizophr Res 45 2000 203–211.Google Scholar
MATRICS Results of the MATRICS RAND panel meeting: average medians for the categories of each candidate test MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) http://www.matrics.ucla.edu/meetings/september-2003/RAND-Panel-Medians.pdf 2003.Google Scholar
McEvoy, J.P.Freter, S.Everett, G.Geller, J.L.Appelbaum, P.Apperson, L.J. et al Insight and the clinical outcome of schizophrenic patients J Nerv Ment Dis 177 1989 48–51.Google Scholar
Mintz, A.R.Addington, J.Addington, D.Insight in early psychosis: a 1-year follow-up Schizophr Res 67 2004 213–217.Google Scholar
Morgan, K.D.David, A.S.Neuropsychological studies of insight in patients with psychotic disordersAmador, X.F.David, A.Insight and psychosis: awareness of illness in schizophrenia and related disorders 2004 Oxford University Press 177–193.CrossRefGoogle Scholar
Mutsatsa, S.H.Joyce, E.M.Hutton, S.B.Barnes, T.R.Relationship between insight, cognitive function, social function and symptomatology in schizophrenia: the West London first episode study Eur Arch Psychiatry Clin Neurosci 256 2006 356–363.Google Scholar
Nuechterlein, K.H.Barch, D.M.Gold, J.M.Goldberg, T.E.Green, M.F.Heaton, R.K.Identification of separable cognitive factors in schizophrenia Schizophr Res 72 2004 29–39.Google Scholar
O'Sullivan, M.Guilford, J.P.Four factor tests of social intelligence (behavioral cognition): manual of instructions and interpretations 1976 Orange, CA: Sheridan Psychological Services, Inc..Google Scholar
Pedrelli, P.McQuaid, J.R.Granholm, E.Patterson, T.L.McClure, F.Beck, A.T. et al Measuring cognitive insight in middle-aged and older patients with psychotic disorders Schizophr Res 71 2004 297–305.Google Scholar
Reitan, R.M.Trail making test: manual for administration and scoring 1992 Arizona: Reitan Neuropsychology Laboratory.Google Scholar
Riskind, J.Beck, A.Brown, G.Steer, R.Taking the measure of anxiety and depression: validity of the reconstructed Hamilton scales J Nerv Ment Dis 175 1987 474–479.Google Scholar
Rugg, M.D.Wilding, E.L.Retrieval processing and episodic memory Trends Cogn Sci 4 2000 108–115.CrossRefGoogle Scholar
Shad, M.U.Tamminga, C.A.Cullum, M.Haas, G.L.Keshavan, M.S.Insight and frontal cortical function in schizophrenia: a review Schizophr Res 86 2006 54–70.Google Scholar
Shallice, T.Specific impairments of planning Philos Trans R Soc Lond B Biol Sci 298 1982 199–209.Google Scholar
Warman, D.M.Lysaker, P.H.Martin, J.M.Cognitive insight and psychotic disorder: the impact of active delusions Schizophr Res 90 2007 325–333.Google Scholar
Warman, D.M.Martin, J.M.Cognitive insight and delusion proneness: an investigation using the Beck cognitive insight scale Schizophr Res 84 2006 297–304.Google Scholar
Wechsler, D.Wechsler adult intelligence scale3rd ed. 1997 San Antonio, TX: The Psychological Corporation.Google Scholar
Wechsler, D.Wechsler memory scale3rd ed. 1997 New York: The Psychological Corporation.Google Scholar
Weiss, A.P.Heckers, S.Neuroimaging of declarative memory in schizophrenia Scand J Psychol 42 2001 239–250.Google Scholar
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