From Columbia U: Cognitive insight in individuals at clinical high risk for psychosis

http://www.ncbi.nlm.nih.gov/pubmed/23343417

Early Interv Psychiatry. 2013 Jan 24. doi: 10.1111/eip.12023. [Epub ahead of print]

Cognitive insight in individuals at clinical high risk for psychosis.

Kimhy D, Jobson-Ahmed L, Ben-David S, Ramadhar L, Malaspina D, Corcoran CM.

Source

Department of Psychiatry, Columbia University, New York, New York, USA; Center of Prevention and Evaluation, New York State Psychiatric Institute, New York, New York, USA.

Abstract

AIM:

Reduced cognitive insight has been associated with psychotic symptoms, in particular with the presence of delusions; however, there is little information about whether such reductions are present in at-risk individuals prior to the onset of threshold psychotic symptoms.

METHOD:

We conducted a cross-sectional comparison of cognitive insight (as indexed by the Beck Cognitive Insight Scale) in 62 help-seeking individuals at clinical high risk for psychosis, Fifty-nine individuals with schizophrenia-spectrum disorders and 37 healthy controls (HC). In patients, we evaluated associations of insight with positive symptoms, including later transition topsychosis in high-risk patients.

RESULTS:

Individuals with schizophrenia reported significantly higher self-certainty scores than the at-risk patients and HCs, with the at-risk patients scoring intermediate to the individuals with schizophrenia andcontrols. Similarly, individuals with schizophrenia scored significantly higher on self-reflectiveness, with no differences between the at-risk patients and controls. In individuals with schizophrenia, delusions were significantly correlated with self-certainty. In at-risk patients, cognitive insight was not associated with positive symptom severity and did not differentiate those at-risk patients who later developedpsychosis from those who did not. However, post hoc analyses suggested that at-risk patients with marked unusual thought content (approaching threshold psychosis) had lower self-reflectiveness; whereas those with high suspiciousness had significantly higher self-certainty.

CONCLUSIONS:

The findings are discussed in the context of normal developmental processes occurring during adolescence, their putative links to neurobiological functioning, and their implications for treatment and future research.