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Dissociating self-reported cognitive complaint from clinical insight in schizophrenia

Published online by Cambridge University Press:  16 April 2020

Sophie Bayard ,
Delphine Capdevielle ,
Jean-Philippe Boulenger  and
Stéphane Raffard
Sophie Bayard*
Affiliation:
Sleep Disorder Unit, University Department of Neurology, University of Montpellier 1, 34295 Montpellier, Cedex 5, France
Delphine Capdevielle
Affiliation:
University Department of adult Psychiatry, University of Montpellier 1, Montpellier, France INSERM U-888, Montpellier, France
Jean-Philippe Boulenger
Affiliation:
University Department of adult Psychiatry, University of Montpellier 1, Montpellier, France INSERM U-888, Montpellier, France
Stéphane Raffard
Affiliation:
University Department of adult Psychiatry, University of Montpellier 1, Montpellier, France INSERM U-888, Montpellier, France University Department of Clinical Psychology and Neuropsychology, EA 4210, University of Montpellier 3, France
*
*Corresponding author. E-mail address: bayardsophie@yahoo.fr
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Abstract

Whereas new pharmacological treatments are developed for cognitive impairments in schizophrenia, self-assessment of cognitive dysfunctioning besides their objective validity could be of interest in evaluating patients' motivation to engage in rehabilitation program. Nevertheless insight into symptoms is severely impaired in schizophrenia and is negatively linked with poor compliance. But it is yet unknown if patients with poor insight into their symptoms could have some insight into their cognitive impairments. The aim of this study was to explore the relationships existing between the cognitive complaint and the level of awareness of the disease in patients with schizophrenia. A total of 101 patients with DSM-IV schizophrenia or schizoaffective disorder and 60 control participants were recruited. Insight was assessed using the Scale to assess Unawareness of Mental Disorder (SUMD) and cognitive complaint intensity was assessed with the Scale to Investigate Cognition in Schizophrenia (SSTICS). Participants with schizophrenia displayed the same level of cognitive complaint when compared to healthy controls. Strong correlations were observed between SSTICS total score and duration of illness, levels of depression and state anxiety. Patients with a good insight into the therapeutic effects achieved with medication expressed a more important cognitive complaint. No correlations were found between the four others SUMD insight dimensions and total SSTICS score. The partial overlap of insight into illness and cognitive complaint suggests that insight is modular in schizophrenia. Assessment of cognitive complaint and awareness of illness need to be assessed before engagement in rehabilitation program.

Keywords

SchizophreniaInsightCognitive complaintScale to Investigate Cognition in SchizophreniaScale to assess Unawareness of Mental Disorder
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 4 , May 2009 , pp. 251 - 258
Copyright
Copyright © Elsevier Masson SAS 2009

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