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Longitudinal changes of insight in first episode psychosis and its relation to clinical symptoms, treatment adherence and global functioning: One-year follow-up from the Eiffel study

Published online by Cambridge University Press:  15 April 2020

R. Segarra ,
N. Ojeda ,
J. Peña ,
J. García ,
A. Rodriguez-Morales ,
I. Ruiz ,
R. Hidalgo ,
J.A. Burón ,
J.I.I. Eguiluz  and
M. Gutiérrez
R. Segarra*
Affiliation:
First Episode Psychosis Unit, Psychiatry Department, Cruces Hospital, Plaza de Cruces, s/n. 48903Baracaldo, Spain Psychiatry Department, Basque Country University, B. Sarriena s/n. 48940Leioa, Spain CIBERSAM, Centro de Investigación Biomédica en Red en Salud Mental, Spain
N. Ojeda
Affiliation:
Department of Psychology, University of Deusto, Avenida Universidades, 24, 48007Bilbao, Spain CIBERSAM, Centro de Investigación Biomédica en Red en Salud Mental, Spain
J. Peña
Affiliation:
Department of Psychology, University of Deusto, Avenida Universidades, 24, 48007Bilbao, Spain
J. García
Affiliation:
First Episode Psychosis Unit, Psychiatry Department, Cruces Hospital, Plaza de Cruces, s/n. 48903Baracaldo, Spain
A. Rodriguez-Morales
Affiliation:
Medical Department, Janssen-Cilag, Madrid, Spain
I. Ruiz
Affiliation:
Medical Department, Janssen-Cilag, Madrid, Spain
R. Hidalgo
Affiliation:
Medical Department, Janssen-Cilag, Madrid, Spain
J.A. Burón
Affiliation:
Medical Department, Janssen-Cilag, Madrid, Spain
J.I.I. Eguiluz
Affiliation:
First Episode Psychosis Unit, Psychiatry Department, Cruces Hospital, Plaza de Cruces, s/n. 48903Baracaldo, Spain Psychiatry Department, Basque Country University, B. Sarriena s/n. 48940Leioa, Spain CIBERSAM, Centro de Investigación Biomédica en Red en Salud Mental, Spain
M. Gutiérrez
Affiliation:
Psychiatry Department, Basque Country University, B. Sarriena s/n. 48940Leioa, Spain Psychiatry Department, Santiago Apóstol Hospital, Olaguibel, 29, 01006Vitoria, Spain CIBERSAM, Centro de Investigación Biomédica en Red en Salud Mental, Spain
*
* Corresponding author. Tel.: +34 94 600 6004; fax: +34 94 600 6294. E-mail address:rafael.segarraechevarria@osakidetza.net (R. Segarra).
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Abstract

Objectives

The Eiffel study is a longitudinal, naturalistic study of patients with first episode psychosis (FEP) designed to evaluate the predictive value of defective insight on treatment adherence and global functioning.

Methods

Five hundred seventy-seven patients with FEP were assessed at baseline and at a 1-year follow-up. They were compared in terms of sociodemographic factors, psychopathology, insight, treatment adherence and functional outcome. Longitudinal functionality was prospectively assessed with the clinical global impression (CGI) and global assessment of functioning (GAF) rating scales.

Results

At baseline, up to 50% of our sample presented with a lack of insight. Most clinical symptoms, including insight, improved over the follow-up period. Insight, education and social withdrawal significantly predicted CGI and GAF at follow-up. Insight and level of education were predictive of treatment adherence.

Conclusions

Insight significantly predicted the general clinical course, treatment adherence and functional outcome in our FEP sample after 1 year. Only education additionally accounted for the longitudinal course. Since our results suggest that better insight improves treatment adherence and consequently clinical course and functional outcome, insight could be a specific target of treatment in early intervention programs.

Keywords

First-episode psychosisInsightTreatment adherenceLongitudinal courseFunctional outcomeRisperidone
Type
Original article
Information
European Psychiatry , Volume 27 , Issue 1 , January 2012 , pp. 43 - 49
Copyright
Copyright © Elsevier Masson SAS 2012

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