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Is “clinical” insight the same as “cognitive” insight in schizophrenia?

Published online by Cambridge University Press:  01 May 2009

GARY DONOHOE*
Affiliation:
Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
JUDY HAYDEN
Affiliation:
Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
NICOLA McGLADE
Affiliation:
Cluain Mhuire Family Centre and Department of Psychiatry, University College Dublin, Dublin, Ireland
CARA O’GRÁDA
Affiliation:
Department of Psychiatry, University College Cork, Cork, Ireland
TERESA BURKE
Affiliation:
School of Psychology, University College Dublin, Dublin, Ireland
SANDRA BARRY
Affiliation:
Department of Psychiatry, University College Cork, Cork, Ireland
CARAGH BEHAN
Affiliation:
Cluain Mhuire Family Centre and Department of Psychiatry, University College Dublin, Dublin, Ireland
TIMOTHY G. DINAN
Affiliation:
Department of Psychiatry, University College Cork, Cork, Ireland
EADBHARD O’CALLAGHAN
Affiliation:
Cluain Mhuire Family Centre and Department of Psychiatry, University College Dublin, Dublin, Ireland
MICHAEL GILL
Affiliation:
Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
AIDEN P. CORVIN
Affiliation:
Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
*
*Correspondence and reprint requests to: Gary Donohoe, Department of Psychiatry, Trinity Health Centre, St. James’s Hospital, Dublin 8, Ireland. E-mail: donoghug@tcd.ie

Abstract

Poor insight is associated with impaired cognitive function in psychosis. Whether poor clinical insight overlaps with other aspects of self-awareness in schizophrenia, such as cognitive self-awareness, is unclear. We investigated whether awareness of clinical state (“clinical insight”) and awareness of cognitive deficits (“cognitive insight”) overlap in schizophrenia in a sample of 51 stabilized patients with chronic schizophrenia. Cognitive insight was assessed in terms of the agreement between subjective self-report and neuropsychological assessment. Patients who show good cognitive insight did not necessarily show good clinical insight. By contrast, self-report and objective neuropsychological assessment only correlated for patients in the intact clinical insight group and not for those in the impairment clinical insight group. We conclude that while good cognitive insight may not be necessary for good clinical insight, good cognitive awareness is at least partly reliant on the processes involved in clinical insight. (JINS, 2009, 15, 471–475.)

Type
Brief Communications
Copyright
Copyright © The International Neuropsychological Society 2009

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