Changes in insight in psychotic patients

Abstract

Several studies have tried to correlate insight in psychotic patients with psychosocial functioning, manifestations of anxiety and depression, altered activation and brain function, disease severity, neurocognitive impairment, number of hospitalizations, gains in psychotherapy, treatment adherence and risk of suicide, indicating insight can work as an indicator of prognosis. Some studies have examined the change in insight during treatment of psychosis, finding, for example, significant relationship between improvement of symptoms and improvement of insight in patients with schizophrenia, but worsening insight is not associated with worsening positive symptoms in these patients. However, usually there is no comparison in the change in insight between the different types of psychotic disorders during their treatments. OBJECTIVE: To analyze the evolution of insight in patients with different psychotic disorders hospitalized in the HC-Unicamp (Campinas-SP), seeking to identify factors associated with improved insight and compare patients with affective psychoses and non-affective psychoses about the change in insight and associated factors. Subjects and methods: Immediately after the psychotic patients hospitalized in the HC-Unicamp, sign the agreement form, and the legal guardian sign the consent form, the Brazilian version of "Schedule for the Assessment of Insight - Expanded Version" will be applied to these patients, at two different times: on admission to the Psychiatric Ward of, as soon as they have clinical conditions to respond to the interview, and the imminence of his departure. The project will be sent to the Research Ethics Committee of UNICAMP. Expected contribution: A continued look on the insight is revelant; so, given its clinical prognostic value, this project aims to explore whether there is development of insight in psychotic patients during psychiatric hospitalization, and if this evolution is correlated with other socio-demographic, clinical and psychopathological variables, including if the psychotic disorder presented by the patient is the type affective or not. We hope to obtain further knowledge about the manifestation of insight in different psychotic disorders and provide elements for the development of strategies to promote improved insight during hospitalization of psychotic patients.