Los predictores de "insight" con respecto a la enfermedad mental entre los pacientes psicóticos y no psicóticos

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Abstract

El propósito de este estudio fue 1) Crear un índice de "insight" en relación con la enfermedad mental 2) Examinar los predictores de "insight" entre una muestra regional representativa compuesta por 418 pacientes. El "insight" se definió mediante un índice basado en tres cuestiones. Además de estas cuestiones fue tenida en cuenta la estimación hecha por el entrevistador utilizando así mismo un índice. Un buen "insight" o uno "moderado" estaba asociado con una edad joven, estado civil de casado o bien de "conviviente", la existencia de confidente íntimo, el diagnóstico de un trastorno afectivo, de uno ansioso o bien de un trastorno de adaptación, así como de dependencias al alcohol o a otras drogas, baja gravedad de la enfermedad, baja edad del primer tratamiento, alta validación del tratamiento y pocas admisiones durante el periodo de estudio. Utilizando el análisis discriminante se consiguió una clasificación grupal correcta en el 44% del total de pacientes. El índice parece ser una medida rápida y aceptable que puede encontrar aplicación como método para medir los diferentes niveles de "insight".

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Most cited references 61

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Awareness of illness in schizophrenia and schizoaffective and mood disorders.

Maureen J. Gorman, M Flaum, Bradley H Strauss … (1994)

The literature on insight, or self-awareness, in schizophrenia suggests that this cognitive dimension may be of nosological value. Poor insight has descriptive validity at the phenomenological and neuropsychological levels of schizophrenia and has prognostic validity in terms of the prediction of the course of illness. The lack of empirical data on the diagnostic specificity of poor insight to schizophrenia and the previous use of insight measures with questionable reliability and validity have limited this interpretation. In the present study, we assessed insight into multiple aspects of mental disorder using a measure with demonstrated reliability and validity. A sample of 412 patients with psychotic and mood disorders coming from geographically diverse regions of the United States and one international site was studied. The main aims were to determine the prevalence of self-awareness deficits in patients in whom schizophrenia was diagnosed, to examine the relative severity of self-awareness deficits associated with schizophrenia compared with that of schizoaffective and mood disorders with and without psychosis, and to evaluate the clinical correlates of self-awareness in patients with schizophrenia. The results indicated that poor insight is a prevalent feature of schizophrenia. A variety of self-awareness deficits are more severe and pervasive in patients with schizophrenia than in patients with schizoaffective or major depressive disorders with or without psychosis and are associated with poorer psychosocial functioning. The results suggest that severe self-awareness deficits are a prevalent feature of schizophrenia, perhaps stemming from the neuropsychological dysfunction associated with the disorder, and are more common in schizophrenia than in other psychotic disorders.

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Assessment of insight in psychosis.

J Endicott, X Amador, Bradley H Strauss … (1993)

It is frequently reported that patients with psychotic disorders have poor insight into their illness. Previous research has suggested that poor insight may have considerable power in predicting the long-term course of chronic mental disorders and an impact on patients' compliance with treatment plans. The authors, proposing that insight is best viewed as a multidimensional phenomenon, developed the Scale to Assess Unawareness of Mental Disorder, which samples discrete and global aspects of insight across a variety of manifestations of illness. This article reports on a reliability and validity study of the scale. The study subjects were 43 patients with schizophrenia and schizoaffective disorder. Various aspects of insight into illness were evaluated with the scale. In addition, ratings of psychopathology, course of illness, and compliance with treatment were made. Item variability was high and normally distributed, supporting the authors' contention that insight can be rated on a continuous rather than dichotomous scale. Results of the analyses examining the relations between the various dimensions of insight assessed and the psychopathology, course, and compliance variables were generally as hypothesized. Convergent validity with other global measures of insight was found, and aspects of poor insight were correlated with poorer compliance and course of illness. Examination of the interrelations among the four insight subscales revealed that these subscales sample independent phenomena. The Scale to Assess Unawareness of Mental Disorder has good reliability and validity and has certain advantages over previous measures of insight, suggesting the usefulness of a multidimensional view of this complex concept.

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The assessment of insight in psychosis.

Patricia Buchanan, Marco A O Almeida, Scott Reed … (1992)

An assessment schedule was used to determine the nature of insight in 91 mixed psychotic patients, and to examine its distribution and associations. While all the components of the schedule intercorrelated significantly, scores for compliance were only weakly related to those for ability to label psychotic phenomena as abnormal. Compliance and illness recognition were related to IQ. Total insight score was inversely correlated, moderately, with a global measure of psychopathology derived from the PSE, and was less in patients involuntarily committed. Age, sex, diagnosis, and the number of previous hospital admissions had little effect. The results support the notion that insight is not a unitary concept.

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Author and article information

Contributors

Andrea Lang: Role: ND

Gerlinde Berghofer: Role: ND

Anita Kager: Role: ND

Egbert Steiner: Role: ND

Margot Schmitz: Role: ND

Friedrich Schmidl: Role: ND

Stephan Rudas: Role: ND

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Journal ID (publisher): ejp

Title: The European journal of psychiatry (edición en español)

Abbreviated Title: Eur. J. Psychiat. (Ed. esp.)

Publisher: Universidad de Zaragoza (Zaragoza )

ISSN: 1579-699X

Publication date (Print): October 2003

Volume: 17

Issue: 4

Pages: 199-209

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[1 ] Servicios Comunitarios de Salud Mental AUSTRIA

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Publisher ID: S1579-699X2003000400002

SO-VID: 6b9c3102-533b-4583-9ab5-51cf74be2219

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http://creativecommons.org/licenses/by/4.0/

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Self URI (journal page): http://scielo.isciii.es/scielo.php?script=sci_serial&pid=1579-699X&lng=en

Los predictores de "insight" con respecto a la enfermedad mental entre los pacientes psicóticos y no psicóticos

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Most cited references 61

Awareness of illness in schizophrenia and schizoaffective and mood disorders.

Assessment of insight in psychosis.

The assessment of insight in psychosis.

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