INSIGHT IN SEASONAL AFFECTIVE-DISORDER

Lack of insight complicates the evaluation and treatment of patients w ith psychotic and affective disorders. No studies of insight in season al affective disorder (SAD) have been reported. Thirty patients with S AD diagnosed by the Structured Clinical Interview for DSM-III-R but no other axis I conditions were treated short-term with light-therapy. I nsight was measured with the Scale to Assess Unawareness of Mental Dis order (SUMD) as modified by the authors to assess the self-report of i nsight into depressive symptoms. Increasing scores (1 to 5) indicated increasing unawareness of illness (i.e., less insight). SAD patients d isplayed a moderate amount of insight when depressed (mean SUMD score, 2.5), When recovered, they showed no significant change in insight in to past depressive symptoms (mean SUMD score, 2.8). Greater insight in to current depressive symptoms correlated with more depressive symptom s on the Hamilton Rating Scale for Depression score ([HRSD] r = .35, P < .05). In conclusion, SAD patients possess a moderate amount of insi ght into depressive symptoms that does not change after recovery, a re sult in agreement with studies of insight in psychosis and mania. Furt her, in SAD, increased severity of illness may be associated with incr eased insight into depressive symptoms, consistent with the hypothesis of depressive realism. Copyright (C) 1997 by W.B. Saunders Company.