Patients with first episodes of schizophreniform disorder, schizophrenia, schizoaffective disorder, delusional disorder, and psychosis not otherwise specified were recruited from July 1996 to September 1998 from consecutive admissions to day-patient and inpatient units in England.
- Patients were interviewed with the BIS, an 8-item self-completed scale.
At final interviews, medical notes were scored independently of the rater to determine dates of relapse.
- This was defined as an exacerbation of positive symptoms lasting at least 2 weeks, leading to a change in management.
Hospitalization data were obtained from the National Health Service hospitals in the catchment area.
Insight at baseline was significantly lower in those who relapsed (mean BIS = 8.8) than in those who did not (mean BIS = 10.3).
Mean BIS was lower in those who were rehospitalized (mean = 8.1) than in those who were not (mean = 10.2).
The hazard ratio for relapse, per unit increase in the insight score, was estimated to be 0.943.
The rate of relapse in patients with the best insight scores was 39% of the rate among patients with the worst insight scores.
Poor insight also predicted readmission (hazard ratio, 0.924).
Reference:
Drake RJ, Dunn G, Tarrier N, Bentall RP, Haddock G, Lewis SW. Insight as a predictor of the outcome of first-episode nonaffective psychosis in a prospective cohort study in England. J Clin Psychiatry. 2007; 68(1): 81-86.