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The association between insight and symptoms in bipolar inpatients: An Italian prospective study

Published online by Cambridge University Press:  30 November 2011

C. Bressi ,
M. Porcellana ,
P.M. Marinaccio ,
E.P. Nocito ,
M. Ciabatti ,
L. Magri  and
A.C. Altamura
C. Bressi*
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122Milan, Italy
M. Porcellana
Affiliation:
Department of Mental Health, AO Ospedale Niguarda Ca’ Granda, Piazza Ospedale Maggiore 3, 20162Milan, Italy
P.M. Marinaccio
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122Milan, Italy
E.P. Nocito
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122Milan, Italy
M. Ciabatti
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122Milan, Italy
L. Magri
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122Milan, Italy
A.C. Altamura
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122Milan, Italy
*
*Corresponding author. Tel.: +39 0255035986; fax: ++39 0250320310. E-mail address:[email protected] (C. Bressi).
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Abstract

Objective

To evaluate potential differences in insight among bipolar manic, mixed and bipolar depressed inpatients and assess the role of clinical and demographic characteristics as possible predictors.

Method

One hundred and twenty consecutive inpatients divided into three diagnostic groups were studied on admission (T0), at discharge (T1) and at 18weeks after hospitalization (T2). The Young Mania Rating Scale (YMRS), the Hamilton Rating Scale for Depression (HAMD) and the Scale to Assess Unawareness of Mental Disorder (SUMD) were used.

Results

Patients with mixed mania showed highest scores on the SUMD than patients with mania or bipolar depression. It was found a significant relationship between improvements in mania and in the insight. The level of insight at baseline was the only predictor of awareness in social consequences, moreover clinical and demographic characteristics were predictors of insight into mental illness. For what concerns insight about therapy benefits it was influenced by level of mania at baseline.

Conclusion

The three general dimensions of insight revealed significant differences among the three groups. Regression models suggest that insight is a multidimensional concept in which some aspects are state-related, associated with psychopathology, whereas others are trait-like qualities, not directly associated with symptoms and predicted only by level at baseline.

Keywords

Bipolar disorderInsightQuality of life
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 8 , November 2012 , pp. 619 - 624
Copyright
Copyright © European Psychiatric Association 2012

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