Unawareness of illness and neurocognition in schizophrenia
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Psychiatr Pol 2008;42(6):943–957
Aim. The aim of the study was to investigate the relationship between insight and cognitive function in patients diagnosed with schizophrenia. Insight into illness is a clinically important feature influencing clinical outcome and prognosis in schizophrenia. One of the most important and widely discussed in recent literature factors contributing to lack of insight is cognitive dysfunction, mainly that mediated by deficits in the frontal cortical systems. A number of studies, but not all, have observed correlations between unawareness in different insight dimensions and poor performance on working memory and executive function tests. Method. 102 individuals were included to the study, the SUMD scale (Scale for Assessment of Unawareness of Mental Disorder) was used to asses the insight, and the battery of the neuropsychological test was administrated to assess cognition. Results. The results indicate that only some of the insight dimensions were associated with neuropsychological assessment. The research confirmed some relationship between unawareness of effects of medications and memory functions and correlations between unawareness of social consequences of illness and executive functions. Relations between other insight dimensions and neurocognition was less clear, only unawareness of negative symptoms was related to the working memory test. Conclusions. Lack of insight in schizophrenia was moderately associated with cognitive functions. Unawareness of the effects of medication was related to the working memory and learning process, unawareness of social consequences of the mental disorder was related to executive functions. Unawareness of negative symptoms showed stronger associations with cognition than unawareness of positive symptoms or disorganization.