Insight, social functioning and readmission to hospital in patients with schizophrenia-spectrum disorders: Prospective associations

Abstract It has been claimed that insight is capable of predicting important clinical outcomes among people with schizophrenia. However, the supporting evidence is sparse. Although many cross-sectional studies have been undertaken, only prospective studies can provide convincing evidence. The aims o...

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Bibliographic Details
Published in:Psychiatry research 2010-06, Vol.178 (1), p.17-22
Main Authors: Startup, Mike, Jackson, Mike C, Startup, Sue
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adult and adolescent clinical studies
Biological and medical sciences
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Insight
Institution therapy. Inpatient treatment
Male
Medical sciences
Middle Aged
Patient Readmission - statistics & numerical data
Predictive Value of Tests
Prospective Studies
Prospective study
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Readmission
Regression Analysis
Schizophrenia
Schizophrenia - physiopathology
Schizophrenic Psychology
Social Behavior
Social functioning
Time Factors
Treatments
Young Adult
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Summary:Abstract It has been claimed that insight is capable of predicting important clinical outcomes among people with schizophrenia. However, the supporting evidence is sparse. Although many cross-sectional studies have been undertaken, only prospective studies can provide convincing evidence. The aims of the present research were to assess the ability of insight to predict subsequent readmissions to hospital and social functioning. Patients with schizophrenia-spectrum disorders ( N = 90) were recruited at the time of an acute psychotic episode and then re-assessed after 6, 12, and 24 months. Assessments included insight, three measures of social functioning, and symptoms of psychosis. There was no evidence that having been readmitted to hospital since a previous assessment was associated with insight at the previous assessment. None of the associations between insight at one assessment and social functioning at subsequent assessments was significant. Changes in insight were associated with changes in contemporary functioning, but it was found that changes in insight made no significant contributions to changes in functioning which were independent of changes in symptoms. The general aim of improving clinical outcomes would probably be better met with interventions designed to improve functioning rather than interventions to improve insight.
ISSN:0165-1781
1872-7123
DOI:10.1016/j.psychres.2010.01.002