Citation

Otheman Y, Doufiq J, Kasouati J, Yahia A, Mehssani J, Ouanass A, Bichra MZ. Ann. Med. Psychol. (Paris) 2014; 172(5): 363-368.

Copyright

(Copyright © 2014, Societe Medico-Psychologique, Publisher Elsevier Publishing)

DOI

10.1016/j.amp.2013.02.012

PMID

unavailable

Abstract

INTRODUCTION: Population et méthode: Résultats: Conclusions: Introduction: Insight is a multidimensional concept first used in schizophrenia and in several psychiatric disorders including bipolar disorder. Its improvement is a major issue in patient's treatment. The aim of our study was to compare insight in schizophrenia and bipolar disorder during and after psychotic and manic episodes, and whether the factors influencing insight in these two disorders are the same, in order to deduce the therapeutic implications. Population and method: We first evaluated and compared insight of 46 schizophrenics and 41 bipolar patients in the beginning and end of hospitalization, using Q8 scale and Birchwood IS scale (with its three sub-scales). Then, we analyzed various demographic factors (age, sex, occupation and marital status), and clinical factors (history of hospitalization, suicidal ideation, suicide attempts, aggression against others, drug use, psychiatric family history, duration and type of treatment).

RESULTS: Patients in this study are mostly young adults, male, not living with a partner. Schizophrenic patients are less well integrated in terms of profession and family. At the beginning of hospitalization, insight is low for both populations, but it is relatively better in bipolar patients with a greater awareness of symptoms. We observed a marked improvement in all dimensions of insight in patients with bipolar disorder at the end of hospitalization. Schizophrenic patients improved their awareness of symptoms and need of treatment, while their awareness of the disease remains poor. Multivariate analysis shows that factors influencing the scores of insight for both populations are: the type of treatment (atypical antipsychotics for schizophrenics and mood stabilizers for bipolar patients) and the presence of a personal history of suicidal ideation.

CONCLUSIONS: In schizophrenic population, it seems more appropriate to work on the consciousness of the need for treatment. Psycho-educational measures and psychotherapeutic interventions targeting the improvement of insight are useful but must be accompanied with monitoring and management of depressive complication and suicidal tendencies in both populations. © 2013 Elsevier Masson SAS.

Language: fr

Keywords

adult; human; age; female; male; bipolar disorder; Bipolar disorder; Schizophrenia; suicidal ideation; sex difference; aggression; schizophrenia; psychosis; drug use; suicide attempt; hospitalization; occupation; risk factor; awareness; article; comparative study; major clinical study; neuroleptic agent; marriage; rating scale; ethnic group; family history; hospital patient; mania; Insight; mood stabilizer; Birchwood IS scale; Moroccan (people); Q8 scale