Insight, social functioning and readmission to hospital in patients with schizophrenia-spectrum disorders: Prospective associations

• Published in: Psychiatry research Vol. 178; no. 1; pp. 17 - 22
• Main Authors: Startup, Mike, Jackson, Mike C, Startup, Sue
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ireland Ltd 30.06.2010; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Insight; Institution therapy. Inpatient treatment; Male; Medical sciences; Middle Aged; Patient Readmission - statistics & numerical data; Predictive Value of Tests; Prospective Studies; Prospective study; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Readmission; Regression Analysis; Schizophrenia; Schizophrenia - physiopathology; Schizophrenic Psychology; Social Behavior; Social functioning; Time Factors; Treatments; Young Adult; Schizophrenia; Insight; Readmission; Social functioning; Prospective study; Human; Social adjustment; Self perception; Psychosis; Symptomatology; Rehospitalization; Social interaction; Follow up study; Predictive factor
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2010.01.002

Abstract It has been claimed that insight is capable of predicting important clinical outcomes among people with schizophrenia. However, the supporting evidence is sparse. Although many cross-sectional studies have been undertaken, only prospective studies can provide convincing evidence. The aims of the present research were to assess the ability of insight to predict subsequent readmissions to hospital and social functioning. Patients with schizophrenia-spectrum disorders ( N = 90) were recruited at the time of an acute psychotic episode and then re-assessed after 6, 12, and 24 months. Assessments included insight, three measures of social functioning, and symptoms of psychosis. There was no evidence that having been readmitted to hospital since a previous assessment was associated with insight at the previous assessment. None of the associations between insight at one assessment and social functioning at subsequent assessments was significant. Changes in insight were associated with changes in contemporary functioning, but it was found that changes in insight made no significant contributions to changes in functioning which were independent of changes in symptoms. The general aim of improving clinical outcomes would probably be better met with interventions designed to improve functioning rather than interventions to improve insight.