Journal List > Korean J Schizophr Res > v.18(2) > 1057819

Uh, Lee, Han, Paika, and Kim: Relationship of Insight with Cognitive Function, Psychopathology and Psychosocial Factors in Patients with Schizophrenia

Abstract

Objective

The purpose of this study is to evaluate the relationship of insight with sociodemographic, clinical, and cognitive parameters in schizophrenic patients.

Methods

Seventy-seven patients with schizophrenia were recruited. All subjects completed the Korean version of the revised Insight Scale of Psychosis (KISP) and Multidimensional Scale of Perceived Social Support (MSPSS). Positive and Negative symptom scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Neurocognitive function tests were also administered.

Results

Patients that are married or currently living together showed significantly higher levels of insight than those who are di-vorced, separated, or single. Insight showed positive correlations with CDSS and emotional discomfort factor of PANSS. Insight also had negative correlations with age of onset and family, friend subscales of MSPSS. Total scores of PANSS and neurocognitive functions showed no significant correlations with insight. More severe depressive symptoms, lower perceived social support from friends and family, and younger age of onset were predictor of higher insight.

Conclusion

The study suggest that impaired insight might be independent from general psychopathology and cognitive function and more influenced by emotional status and social environment.

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Table 1.
Sociodemographic characteristics of the subjects (n=77)
n (%) Mean± SD
Age (years) 42.29±11.30
 Sex
 Male 30 (39.0%)
Female 47 (61.0%)
Occupation
 Unemployed 56 (73.7%)
 Employed 21 (26.3%)
Marital status
 Married/living together 45 (58.4%)
 Single 24 (31.2%)
 Divorced/separated 8 (10.4%)
Education (years) 5.91±4.06
Age of onset (years) 28.55±10.64
Duration of illness (years) 9.26±8.07

Number of hospitalization 1.44±1.38

Table 2.
Clinical characteristics and neuropsychological tests scores of the subjects (n=77)
Mean± SD
KISP 012.91±5.63
CDSS 003.13±3.65
PANSS (total) 056.38±18.34
 Positive factor 011.23±4.33
 Negative factor 017.57±6.80
 Cognitive factor 012.95±4.28
 Emotional disturbance factor 008.93±2.92
 Hostility factor 006.07±2.74
MSPSS (total) 050.45±15.11
 Family 019.38±6.05
 Friend 014.96±7.08
 Others 016.12±6.55
Total IQ 101.55±11.94
 Verbal IQ 103.34±9.75
 Performance IQ 099.48±13.14
Digit span Verbal fluency 037.42±21.01014.07±4.45
TMT A (sec) TMT B (sec) 042.20±19.88101.71±40.08

KISP : Korean version of Insight Scale for Psychosis, CDSS : Calgary Depression scale for Schizophrenia, PANSS : Positive and Negative symptoms scale, MSPSS : Multidimensional Scale of Perceived social support, IQ : Intelligence Quotient, TMT : Trail Making Test

Table 3.
Comparison of KISP scores according to the demograph-c data
Score of KISP
Mean± SD p-value
Sex
 Male 12.47±5.86 0.714
 Female 13.19±5.53
Occupation
 Unemployed 12.57±5.75 0.301
 Employed 14.10±5.31
Marital status
 Married/living together 14.91±6.07 0.002
 Single 10.46±3.04
 Divorced/Separated 09.00±4.31

: p<0.05, p-values were calculated using the independent samples t-test, † : Kruskal-wallis analysis was performed. KISP : Korean version of Insight Scale for Psychosis

Table 4.
Correlations of KISP scores with clinical measures, and neuropsychological test scores of the subjects (n=77)
R p-value
Age -0.176 0.114
Educational level -0.082 0.468
Onset age -0.24 0.030
Duration of illness 0.063 0.577
Number of hospitalization 0.009 0.941
PANSS
 Negative factor 0.139 0.236
 Positive factor 0.221 0.059
 Cognitive factor 0.071 0.549
 Emotional discomfort factor 0.311 0.007
 Hostility factor 0.039 0.741
CDSS 0.532 <0.001
MSPSS
 Family -0.357 0.001
 Friend –0.369 0.001
Others -0.161 0.149
Verbal IQ -0.262 0.170
Performance IQ -0.107 0.582
Total IQ -0.108 0.551
Digit span -0.047 0.680
Verbal fluency -0.014 0.906
TMT A 0.132 0.261
TMT B 0.092 0.505

: p<0.05, p-values were calculated using the Pearson's cor-relation analysis. KISP : Korean version of Insight Scale for Psychosis, PANSS : Positive and Negative symptoms scale, CDSS : Calgary Depression scale for Schizophrenia, MSPSS : Multidimensional Scale of Perceived social support, IQ : Intelligence

Table 5.
Multiple linear regression analyses for clinical variables related with insight in the subjects (n=77)
B S.E t p-value
CDSS 0.702 0.133 5.295 <0.001
MSPSS (family) -0.300 0.082 -3.643 0.001
MSPSS (friend) -0.156 0.071 -2.203 0.031
Onset age -0.140 0.046 -3.052 0.003

B : Coefficient, S.E : Standard Error, CDSS : Calgary Depression scale for Schizophrenia, MSPSS : Multidimensional Scale of Perceived social support

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