Insight in first-episode psychosis

Joseph P. McEvoy, Jackie Johnson, Diana Perkins, Jeffrey A. Lieberman, Robert M. Hamer, Richard S.E. Keefe, Mauricio Tohen, Ira D. Glick, Tonmoy Sharma

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background. We report here a study examining the relationships between insight and psychopathology, cognitive performance, brain volume and co-morbid depression in 251 patients experiencing a first episode of psychosis, who were then randomly assigned to 2 years of double-blind treatment with either olanzapine or haloperidol. Method. Repeated measures of insight were obtained at baseline and 12, 24, 52 and 104 weeks by the Insight and Treatment Attitudes Questionnaire (ITAQ). Results. Older age, female gender and white ethnicity were associated with more insight. Higher total, positive, negative and general psychopathology scores on the Positive and Negative Syndromes Scale (PANSS) were associated with less insight. Higher depression scores were associated with more insight. Better neurocognitive function and large brain volumes were associated with more insight. More insight throughout the study was associated with longer time to medication non-adherence. However, baseline insight was not significantly related to the probability of discontinuing the study before 2 years. Insight improved significantly over the course of the study, but the improvement in insight was not significantly different between the two antipsychotic treatment groups. Conclusions. Multiple factors contribute to insight. Patients experiencing a first episode of psychosis who have little insight are at increased risk of discontinuing their medication.

Original languageEnglish (US)
Pages (from-to)1385-1393
Number of pages9
JournalPsychological Medicine
Volume36
Issue number10
DOIs
StatePublished - Oct 1 2006

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Psychotic Disorders
olanzapine
Psychopathology
Depression
Medication Adherence
Brain
Haloperidol
Antipsychotic Agents
Therapeutics
Surveys and Questionnaires

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

Cite this

McEvoy, J. P., Johnson, J., Perkins, D., Lieberman, J. A., Hamer, R. M., Keefe, R. S. E., ... Sharma, T. (2006). Insight in first-episode psychosis. Psychological Medicine, 36(10), 1385-1393. https://doi.org/10.1017/S0033291706007793

Insight in first-episode psychosis. / McEvoy, Joseph P.; Johnson, Jackie; Perkins, Diana; Lieberman, Jeffrey A.; Hamer, Robert M.; Keefe, Richard S.E.; Tohen, Mauricio; Glick, Ira D.; Sharma, Tonmoy.

In: Psychological Medicine, Vol. 36, No. 10, 01.10.2006, p. 1385-1393.

Research output: Contribution to journalArticle

McEvoy, JP, Johnson, J, Perkins, D, Lieberman, JA, Hamer, RM, Keefe, RSE, Tohen, M, Glick, ID & Sharma, T 2006, 'Insight in first-episode psychosis', Psychological Medicine, vol. 36, no. 10, pp. 1385-1393. https://doi.org/10.1017/S0033291706007793
McEvoy JP, Johnson J, Perkins D, Lieberman JA, Hamer RM, Keefe RSE et al. Insight in first-episode psychosis. Psychological Medicine. 2006 Oct 1;36(10):1385-1393. https://doi.org/10.1017/S0033291706007793
McEvoy, Joseph P. ; Johnson, Jackie ; Perkins, Diana ; Lieberman, Jeffrey A. ; Hamer, Robert M. ; Keefe, Richard S.E. ; Tohen, Mauricio ; Glick, Ira D. ; Sharma, Tonmoy. / Insight in first-episode psychosis. In: Psychological Medicine. 2006 ; Vol. 36, No. 10. pp. 1385-1393.
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