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The relation between neurocognitive dysfunction and impaired insight in patients with schizophrenia

Published online by Cambridge University Press:  16 April 2020

Viktoria Simon ,
Marc De Hert ,
Martien Wampers ,
Joseph Peuskens  and
Ruud van Winkel
Viktoria Simon
Affiliation:
Semmelweis University Budapest, Department of Psychiatry and Psychotherapy, Balassa u. 6., 1083Budapest, Hungary
Marc De Hert*
Affiliation:
University Psychiatric Center, Catholic University Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Martien Wampers
Affiliation:
University Psychiatric Center, Catholic University Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Joseph Peuskens
Affiliation:
University Psychiatric Center, Catholic University Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Ruud van Winkel
Affiliation:
University Psychiatric Center, Catholic University Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium Department of Psychiatry and Neuropsychology, EURON, South Limburg Mental Health Research and Teaching Network, Maastricht University, PO Box 616, 6200MDMaastricht, The Netherlands
*
*Corresponding author. University Psychiatric Center, Catholic University Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium. Tel.: +32 2 758 05 11; fax: +32 2 759 98 78. E-mail address: marc.de.hert@uc-kortenberg.be.
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Abstract

Objectives

The present study aimed to (i) evaluate the association between insight and measures of executive functions and working memory in a sample of 132 patients with schizophrenia and (ii) to explore to what proportion neurocognitive dysfunction contributed to the variance in insight after controlling for symptomatology.

Methods

Subjects were evaluated with a standardized neurocognitive test battery and a semi-structured interview, the Psychosis Evaluation tool for Common use by Caregivers (PECC). PECC, apart from evaluating symptoms and side-effects, measures insight on a 4-point scale by two of its dimensions: awareness of having a mental illness (AMI) and awareness of having symptoms attributed to a mental illness (ASAMI). Executive functioning was measured by the Wisconsin Card Sort Test (WCST) and the Trail Making B (TMB). Working memory was measured by the Letter Number Sequencing (LNS) test from the Wechsler Adult Intelligence Scale (WAIS).

Results

Only one significant association was found after correction for multiple testing, between WCST categories completed and AMI (r = −0.29, p = 0.0006). WCST categories completed explained only 7.9% of the variance in AMI, while symptomatology explained 20% of variance in AMI and 16.5% of variance in ASAMI.

Conclusions

The current results show a significant but subtle association with the WCST, which is in agreement with earlier literature. No other associations between cognitive functioning and insight were found. In general, these findings seem to suggest that factors other than cognition have a greater impact on insight in patients with schizophrenia.

Keywords

InsightExecutive functionsWorking memorySchizophrenia
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 4 , May 2009 , pp. 239 - 243
Copyright
Copyright © Elsevier Masson SAS 2009

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