Insight in first episode psychosisrole of time and cognitive reserve

Resumen

Insight is broadly understood as a dimensional concept including: the awareness of one¿s illness, its symptoms and consequences, but insight has mainly been studied as a general construct. Moreover insight has been related to outcome, and it changes over time but the moment in which insight¿s stability starts is not clear. Etiology of insight has been explored by different theories but none have been fully supported by experimental data, the integration of these theories could explain better insight. The main objectives of the present work were the following: to explore change of insight and its dimensions over time, to explore an explanatory model of insight integrating the main etiology theories, and finding out the role of insight, among cognitive and clinical variables, in the prediction of functional outcome. 75 patients with First-Episode-Psychosis were recruited in three hospitals of the Basque Country, with two and six-month of follow-up. T-students were used to analyze insight change over time, step-wise-hierarchical-regressions were used to create the explanatory model of insight and mediational analysis were used to clarify the role of insight in the prediction of functionality. Results showed how insight dimensions were stable from two months on, while general insight improved until six months. Mania and cognitive reserve arose as the explanatory variables of insight and its dimensions. And finally, the relationship among functionality and its predictors was mediated by insight. This study supports the relevance of the moment in which insight is measured, and highlights the possible relevant role of cognitive reserve on insight.