Examination of Clinical and Cognitive Insight in Acute Schizophrenia Patients
Examination of Clinical and Cognitive Insight in Acute Schizophrenia Patients
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DOI：
10.1097/nmd.0b013e3181e4f35d
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发表时间：
2010-07-01
影响因子：
1.9
通讯作者：
Serper, Mark R.
中科院分区：
文献类型：
--
作者：
Greenberger, Cheryl;Serper, Mark R.
缺乏对疾病的洞察力或意识是精神分裂症疾病的一个显著特征，并已成为一个日益重要的研究领域。虽然临床洞察力侧重于对疾病因素的认识，但认知洞察力的概念侧重于纠正错误判断和错误判断的确定性所涉及的认知过程。本研究旨在进一步探讨贝克认知洞察力量表(BCIS)(Beck等人，2004年)在急性分裂情感性精神分裂症(SZ)患者中的临床应用及其统计学一致性。本研究以50例DSM-IV确诊的SZ患者为研究对象，研究了该量表的内部一致性，以及与传统的临床洞察力指标相比，该量表的区分和预测效度。BCIS被发现是一个内部一致和连贯的认知洞察力测量工具。BCIS与临床洞察力无关，表明这两个结构几乎没有经验上的重叠。研究发现，认知洞察力与患者自闭症注意力集中症状的严重程度呈负相关，认知洞察力较强的人表现出较少的自闭症/认知症状。然而，患者的临床洞察力被发现与患者的抑郁症严重程度呈负相关。此外，研究还发现，与居住在限制较少的环境中的患者相比，居住在疗养院环境中的患者的临床洞察力受到的损害更大。根据临床和认知洞察力结构与SZ症状领域的关系，对结果进行了讨论。
Lack of insight or awareness of illness is a hallmark feature of schizophrenic illness and has become an increasingly important area of investigation. Although clinical insight focuses on awareness of illness factors, the concept of cognitive insight focuses on the cognitive processes involved in correcting erroneous judgments and certainty about mistaken judgments. The present study was aimed at further investigating the clinical utility and the statistical coherence of the Beck Cognitive Insight Scale (BCIS) (Beck et al., 2004) in acute schizoaffective and schizophrenia (SZ) patients. The present study examined the internal consistency of the scale, as well as its discriminative and predictive validity relative to a well-established traditional measure of clinical insight in a sample of 50 DSM-IV diagnosed SZ patients, presenting for acute inpatient treatment. The BCIS was found to be an internally consistent and a coherent measure of cognitive insight. The BCIS was unassociated with clinical insight, indicating the 2 constructs share little empirical overlap. Cognitive insight was found to be inversely associated with patients' severity of autistic preoccupation symptoms such that those individuals with more cognitive insight, exhibited fewer autistic/cognitive symptoms. Patients' clinical insight, however, was found to be inversely associated specifically with patients' severity of depression. Additionally, clinical insight was also found to be more impaired in patients residing in nursing home environments relative to their counterparts living in less restrictive settings when outside the hospital. Results are discussed in terms of the relationship between clinical and cognitive insight constructs to SZ symptom domains.