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Relationship between cognition, clinical and cognitive insight in psychotic disorders: a review and meta-analysis

Relationship between cognition, clinical and cognitive insight in psychotic disorders: a review and meta-analysis
Relationship between cognition, clinical and cognitive insight in psychotic disorders: a review and meta-analysis
The neurocognitive theory of insight posits that poor insight in psychotic illnesses is related to cognitive deficits in cognitive self-appraisal mechanisms. In this paper we perform a comprehensive meta-analysis examining relationships between clinical insight and neurocognition in psychotic disorders. We have also completed a meta-analysis of studies examining ‘cognitive insight’, as measured by the Beck Cognitive Insight Scale (BCIS), and its relationshipwith neurocognitive function in patients with psychosis. The clinical insight analysis included data from 72 studies and a total population of 5429 patients. Wefound that insight in psychosiswas significantly associated with total cognition (r = 0.16, p b 0.001), IQ (r = 0.16, p b 0.001), memory (r = 0.13, p b 0.001) and executive function (r = 0.14, p b 0.001). All of these correlations were strongerwhen examined in patients with schizophrenia only. In the BCIS analysis we included 7 studies and 466 patients in total.We found that no significant associations were found between the self-reflectiveness sub-component and neurocognition. By contrast there were significant correlations between the self-certainty subcomponent and memory (r = –0.23, p b 0.001), IQ (r = –0.19, p b 0.001) and total cognition (r = –0.14, p = 0.01). We did not find evidence of significant publication bias in any analyses. Overall, our results indicate that there is a small but significant relationship between clinical insight, some aspects of cognitive insight and neurocognition. These findings reflect the complexity of the insight construct and indicate that while the neurocognitive model is important it is likely to be one of many which contribute to the understanding of this phenomenon.
0920-9964
191-200
Nair, Akshay
affcfe6a-8039-4b33-b945-8c37004ad621
Palmer, Emma Claire
e96e8cb6-2221-4dc7-b556-603f2cf6b086
Aleman, André
dc441341-a7c4-4c9c-9ce3-48f829770308
David, Anthony S.
96d9a2fc-bfe1-45ef-9c56-2a10bd02126a
Nair, Akshay
affcfe6a-8039-4b33-b945-8c37004ad621
Palmer, Emma Claire
e96e8cb6-2221-4dc7-b556-603f2cf6b086
Aleman, André
dc441341-a7c4-4c9c-9ce3-48f829770308
David, Anthony S.
96d9a2fc-bfe1-45ef-9c56-2a10bd02126a

Nair, Akshay, Palmer, Emma Claire, Aleman, André and David, Anthony S. (2014) Relationship between cognition, clinical and cognitive insight in psychotic disorders: a review and meta-analysis. Schizophrenia Research, 152 (1), 191-200. (doi:10.1016/j.schres.2013.11.033).

Record type: Article

Abstract

The neurocognitive theory of insight posits that poor insight in psychotic illnesses is related to cognitive deficits in cognitive self-appraisal mechanisms. In this paper we perform a comprehensive meta-analysis examining relationships between clinical insight and neurocognition in psychotic disorders. We have also completed a meta-analysis of studies examining ‘cognitive insight’, as measured by the Beck Cognitive Insight Scale (BCIS), and its relationshipwith neurocognitive function in patients with psychosis. The clinical insight analysis included data from 72 studies and a total population of 5429 patients. Wefound that insight in psychosiswas significantly associated with total cognition (r = 0.16, p b 0.001), IQ (r = 0.16, p b 0.001), memory (r = 0.13, p b 0.001) and executive function (r = 0.14, p b 0.001). All of these correlations were strongerwhen examined in patients with schizophrenia only. In the BCIS analysis we included 7 studies and 466 patients in total.We found that no significant associations were found between the self-reflectiveness sub-component and neurocognition. By contrast there were significant correlations between the self-certainty subcomponent and memory (r = –0.23, p b 0.001), IQ (r = –0.19, p b 0.001) and total cognition (r = –0.14, p = 0.01). We did not find evidence of significant publication bias in any analyses. Overall, our results indicate that there is a small but significant relationship between clinical insight, some aspects of cognitive insight and neurocognition. These findings reflect the complexity of the insight construct and indicate that while the neurocognitive model is important it is likely to be one of many which contribute to the understanding of this phenomenon.

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e-pub ahead of print date: 16 December 2013
Published date: January 2014

Identifiers

Local EPrints ID: 420558
URI: https://eprints.soton.ac.uk/id/eprint/420558
ISSN: 0920-9964
PURE UUID: 476d9cb9-93ff-4da0-9acb-7adcac5f3873

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Date deposited: 10 May 2018 16:30
Last modified: 13 Mar 2019 18:31

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