INSIGHT IN FIRST-ADMISSION PSYCHOTIC-PATIENTS

Background: The prevalence of insight was examined longitudinally in p sychotic patients with schizophrenia (n = 86), bipolar disorder (n = 5 2), major depressive disorder (n = 35) and other psychoses (n = 16). M ethod: Before discharge and at 6-month follow-up, insight in first-adm ission patients from 10 facilities in Suffolk County, New York was rat ed as part of a modified Hamilton Depression Scale. Results: Initially , 80% of depressives but approximately half with other diagnoses manif ested insight. At follow-up, most patients demonstrated insight except for the schizophrenic patients. After controlling for diagnosis, sign ificant correlates of baseline insight were being married, hospitalize d in a community or academic facility, intelligence and negative sympt oms. At follow-up, after controlling for diagnosis and baseline insigh t, prior treatment was predictive. This finding held for schizophrenic patients separately. Conclusion: Lack of insight is more prevalent in schizophrenia and improves over time. The components of prior treatme nt leading to better insight should be explored.