Awareness of illness moderates self-assessment of psychotic symptoms

Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accur...

Full description

Saved in:
Bibliographic Details
Published in:Australian and New Zealand journal of psychiatry 2022-10, Vol.56 (10), p.1287-1294
Main Authors: Martinez Agulleiro, Luis, de Filippis, Renato, Rosson, Stella, Patil, Bhagyashree, Prizgint, Lara, Talasazan, Nahal, Meltzer, Herbert Y, Kane, John M, Gibbons, Robert D, Guinart, Daniel
Format: Article
Language:English
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c340t-fbc97eda901c5975c0ad9b9e26aee9918458abd4e4fedd29f25f54d8310209403
cites cdi_FETCH-LOGICAL-c340t-fbc97eda901c5975c0ad9b9e26aee9918458abd4e4fedd29f25f54d8310209403
container_end_page 1294
container_issue 10
container_start_page 1287
container_title Australian and New Zealand journal of psychiatry
container_volume 56
creator Martinez Agulleiro, Luis
de Filippis, Renato
Rosson, Stella
Patil, Bhagyashree
Prizgint, Lara
Talasazan, Nahal
Meltzer, Herbert Y
Kane, John M
Gibbons, Robert D
Guinart, Daniel
description Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). Methods: A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. Results: A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings (r = 0.517, 95% confidence interval = [0.392, 0.622], p 
doi_str_mv 10.1177/00048674211057480
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2598542886</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_00048674211057480</sage_id><sourcerecordid>2598542886</sourcerecordid><originalsourceid>FETCH-LOGICAL-c340t-fbc97eda901c5975c0ad9b9e26aee9918458abd4e4fedd29f25f54d8310209403</originalsourceid><addsrcrecordid>eNp9kE9Pg0AQxTdGY2v1A3gxHL1QZ5dddvfY1L9JEy96JgsMSgMsMhDTby_Y6sXE00xmfu8l7zF2yWHJudY3ACBNrKXgHJSWBo7YnEsJIY-5PGbz6R9OwIydEW0BeMSVPmWzSGojtRZzdrv6dB02SBT4Iiir6nutfY6d65ECwqoIHdF4rbHpJ6ilXfbu-zILaFe3va_pnJ0UriK8OMwFe72_e1k_hpvnh6f1ahNmkYQ-LNLMasydBZ4pq1UGLrepRRE7RGu5kcq4NJcoC8xzYQuhCiVzE3EQYCVEC3a99207_zEg9UldUoZV5Rr0AyVCWaOkMCYeUb5Hs84TdVgkbVfWrtslHJKpvORPeaPm6mA_pDXmv4qftkZguQfIvWGy9UPXjHH_cfwCytN3Yg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2598542886</pqid></control><display><type>article</type><title>Awareness of illness moderates self-assessment of psychotic symptoms</title><source>SAGE:Jisc Collections:SAGE Journals Read and Publish 2023-2024:2025 extension (reading list)</source><creator>Martinez Agulleiro, Luis ; de Filippis, Renato ; Rosson, Stella ; Patil, Bhagyashree ; Prizgint, Lara ; Talasazan, Nahal ; Meltzer, Herbert Y ; Kane, John M ; Gibbons, Robert D ; Guinart, Daniel</creator><creatorcontrib>Martinez Agulleiro, Luis ; de Filippis, Renato ; Rosson, Stella ; Patil, Bhagyashree ; Prizgint, Lara ; Talasazan, Nahal ; Meltzer, Herbert Y ; Kane, John M ; Gibbons, Robert D ; Guinart, Daniel</creatorcontrib><description>Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). Methods: A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. Results: A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings (r = 0.517, 95% confidence interval = [0.392, 0.622], p &lt; 0.001). Insight was found to moderate this correlation (β = –0.511, p = 0.005), yet agreement between both measures remained statistically significant for both high (r = 0.621, 95% confidence interval = [0.476, 0.733], p &lt; 0.001) and low insight patients (r = 0.408, 95% confidence interval = [0.187, 0.589], p &lt; 0.001), while psychosis severity was comparable between these groups (for Brief Psychiatric Rating Scale: U = 3057, z = –0.129, p = 0.897; disorganization: U = 2986.5, z = –0.274, p = 0.784 and for CAT-Psychosis: U = 2800.5, z = –1.022, p = 0.307). Subgroup of patients with schizophrenia spectrum disorders showed very similar results. Conclusions: Insight moderates the correlation between self-reported and clinician-rated severity of psychosis, yet CAT-Psychosis remains valid in patients with both high and low awareness of illness.</description><identifier>ISSN: 0004-8674</identifier><identifier>EISSN: 1440-1614</identifier><identifier>DOI: 10.1177/00048674211057480</identifier><identifier>PMID: 34784772</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><ispartof>Australian and New Zealand journal of psychiatry, 2022-10, Vol.56 (10), p.1287-1294</ispartof><rights>The Royal Australian and New Zealand College of Psychiatrists 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-fbc97eda901c5975c0ad9b9e26aee9918458abd4e4fedd29f25f54d8310209403</citedby><cites>FETCH-LOGICAL-c340t-fbc97eda901c5975c0ad9b9e26aee9918458abd4e4fedd29f25f54d8310209403</cites><orcidid>0000-0003-1444-8466 ; 0000-0001-5078-6716</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34784772$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez Agulleiro, Luis</creatorcontrib><creatorcontrib>de Filippis, Renato</creatorcontrib><creatorcontrib>Rosson, Stella</creatorcontrib><creatorcontrib>Patil, Bhagyashree</creatorcontrib><creatorcontrib>Prizgint, Lara</creatorcontrib><creatorcontrib>Talasazan, Nahal</creatorcontrib><creatorcontrib>Meltzer, Herbert Y</creatorcontrib><creatorcontrib>Kane, John M</creatorcontrib><creatorcontrib>Gibbons, Robert D</creatorcontrib><creatorcontrib>Guinart, Daniel</creatorcontrib><title>Awareness of illness moderates self-assessment of psychotic symptoms</title><title>Australian and New Zealand journal of psychiatry</title><addtitle>Aust N Z J Psychiatry</addtitle><description>Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). Methods: A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. Results: A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings (r = 0.517, 95% confidence interval = [0.392, 0.622], p &lt; 0.001). Insight was found to moderate this correlation (β = –0.511, p = 0.005), yet agreement between both measures remained statistically significant for both high (r = 0.621, 95% confidence interval = [0.476, 0.733], p &lt; 0.001) and low insight patients (r = 0.408, 95% confidence interval = [0.187, 0.589], p &lt; 0.001), while psychosis severity was comparable between these groups (for Brief Psychiatric Rating Scale: U = 3057, z = –0.129, p = 0.897; disorganization: U = 2986.5, z = –0.274, p = 0.784 and for CAT-Psychosis: U = 2800.5, z = –1.022, p = 0.307). Subgroup of patients with schizophrenia spectrum disorders showed very similar results. Conclusions: Insight moderates the correlation between self-reported and clinician-rated severity of psychosis, yet CAT-Psychosis remains valid in patients with both high and low awareness of illness.</description><issn>0004-8674</issn><issn>1440-1614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kE9Pg0AQxTdGY2v1A3gxHL1QZ5dddvfY1L9JEy96JgsMSgMsMhDTby_Y6sXE00xmfu8l7zF2yWHJudY3ACBNrKXgHJSWBo7YnEsJIY-5PGbz6R9OwIydEW0BeMSVPmWzSGojtRZzdrv6dB02SBT4Iiir6nutfY6d65ECwqoIHdF4rbHpJ6ilXfbu-zILaFe3va_pnJ0UriK8OMwFe72_e1k_hpvnh6f1ahNmkYQ-LNLMasydBZ4pq1UGLrepRRE7RGu5kcq4NJcoC8xzYQuhCiVzE3EQYCVEC3a99207_zEg9UldUoZV5Rr0AyVCWaOkMCYeUb5Hs84TdVgkbVfWrtslHJKpvORPeaPm6mA_pDXmv4qftkZguQfIvWGy9UPXjHH_cfwCytN3Yg</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Martinez Agulleiro, Luis</creator><creator>de Filippis, Renato</creator><creator>Rosson, Stella</creator><creator>Patil, Bhagyashree</creator><creator>Prizgint, Lara</creator><creator>Talasazan, Nahal</creator><creator>Meltzer, Herbert Y</creator><creator>Kane, John M</creator><creator>Gibbons, Robert D</creator><creator>Guinart, Daniel</creator><general>SAGE Publications</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1444-8466</orcidid><orcidid>https://orcid.org/0000-0001-5078-6716</orcidid></search><sort><creationdate>20221001</creationdate><title>Awareness of illness moderates self-assessment of psychotic symptoms</title><author>Martinez Agulleiro, Luis ; de Filippis, Renato ; Rosson, Stella ; Patil, Bhagyashree ; Prizgint, Lara ; Talasazan, Nahal ; Meltzer, Herbert Y ; Kane, John M ; Gibbons, Robert D ; Guinart, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-fbc97eda901c5975c0ad9b9e26aee9918458abd4e4fedd29f25f54d8310209403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinez Agulleiro, Luis</creatorcontrib><creatorcontrib>de Filippis, Renato</creatorcontrib><creatorcontrib>Rosson, Stella</creatorcontrib><creatorcontrib>Patil, Bhagyashree</creatorcontrib><creatorcontrib>Prizgint, Lara</creatorcontrib><creatorcontrib>Talasazan, Nahal</creatorcontrib><creatorcontrib>Meltzer, Herbert Y</creatorcontrib><creatorcontrib>Kane, John M</creatorcontrib><creatorcontrib>Gibbons, Robert D</creatorcontrib><creatorcontrib>Guinart, Daniel</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Australian and New Zealand journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez Agulleiro, Luis</au><au>de Filippis, Renato</au><au>Rosson, Stella</au><au>Patil, Bhagyashree</au><au>Prizgint, Lara</au><au>Talasazan, Nahal</au><au>Meltzer, Herbert Y</au><au>Kane, John M</au><au>Gibbons, Robert D</au><au>Guinart, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Awareness of illness moderates self-assessment of psychotic symptoms</atitle><jtitle>Australian and New Zealand journal of psychiatry</jtitle><addtitle>Aust N Z J Psychiatry</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>56</volume><issue>10</issue><spage>1287</spage><epage>1294</epage><pages>1287-1294</pages><issn>0004-8674</issn><eissn>1440-1614</eissn><abstract>Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). Methods: A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. Results: A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings (r = 0.517, 95% confidence interval = [0.392, 0.622], p &lt; 0.001). Insight was found to moderate this correlation (β = –0.511, p = 0.005), yet agreement between both measures remained statistically significant for both high (r = 0.621, 95% confidence interval = [0.476, 0.733], p &lt; 0.001) and low insight patients (r = 0.408, 95% confidence interval = [0.187, 0.589], p &lt; 0.001), while psychosis severity was comparable between these groups (for Brief Psychiatric Rating Scale: U = 3057, z = –0.129, p = 0.897; disorganization: U = 2986.5, z = –0.274, p = 0.784 and for CAT-Psychosis: U = 2800.5, z = –1.022, p = 0.307). Subgroup of patients with schizophrenia spectrum disorders showed very similar results. Conclusions: Insight moderates the correlation between self-reported and clinician-rated severity of psychosis, yet CAT-Psychosis remains valid in patients with both high and low awareness of illness.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>34784772</pmid><doi>10.1177/00048674211057480</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1444-8466</orcidid><orcidid>https://orcid.org/0000-0001-5078-6716</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0004-8674
ispartof Australian and New Zealand journal of psychiatry, 2022-10, Vol.56 (10), p.1287-1294
issn 0004-8674
1440-1614
language eng
recordid cdi_proquest_miscellaneous_2598542886
source SAGE:Jisc Collections:SAGE Journals Read and Publish 2023-2024:2025 extension (reading list)
title Awareness of illness moderates self-assessment of psychotic symptoms
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T23%3A23%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Awareness%20of%20illness%20moderates%20self-assessment%20of%20psychotic%20symptoms&rft.jtitle=Australian%20and%20New%20Zealand%20journal%20of%20psychiatry&rft.au=Martinez%20Agulleiro,%20Luis&rft.date=2022-10-01&rft.volume=56&rft.issue=10&rft.spage=1287&rft.epage=1294&rft.pages=1287-1294&rft.issn=0004-8674&rft.eissn=1440-1614&rft_id=info:doi/10.1177/00048674211057480&rft_dat=%3Cproquest_cross%3E2598542886%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c340t-fbc97eda901c5975c0ad9b9e26aee9918458abd4e4fedd29f25f54d8310209403%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2598542886&rft_id=info:pmid/34784772&rft_sage_id=10.1177_00048674211057480&rfr_iscdi=true