Insight changes in acute psychotic episodes - A prospective study of Hong Kong Chinese patients

Insight impairment occurs commonly in psychotic disorders (including mood e pisodes with psychotic symptoms). The aim of the present study is to measur e changes of insight over the course of a psychotic episode and to investig ate its relationships with symptoms and neurocognitive functions, as well a s psychosocial factors. Insight was assessed at weekly intervals in 80 cons ecutive inpatients presenting with a psychotic episode by using a Chinese t ranslation of the Scale to Assess Unawareness of Mental Disorder (SUMD). Th e relationships between insight change and other variables were explored. M odest but significant changes in insight were found in both directions with clinical resolution of psychotic symptoms. In particular, insight "decline d" as symptoms improved in a number of patients. In addition, changes in in sight score correlated with changes in Wisconsin Card Sorting Test (WCST) p erformance. More changes in insight (in either direction) tended to occur i n younger patients. These results indicated that adequate control of psycho tic symptoms and improvement in neuropsychological functioning might be ass ociated with better insight recovery.