CLINICAL AND PSYCHOSOCIAL CORRELATES OF INSIGHT IN ADULT PATIENTS WITH EARLY PSYCHOSIS IN HONG KONG

Abstract

Background: Impairment in insight is an important feature in psychotic disorder. It is recognized that poor insight is prevalent in patients with early psychosis. The current study aimed to examined clinical and psychosocial correlates of insight in a representative cohort of Chinese adult patients who had completed 3-year specialized early intervention service for first-episode psychosis (FEP) in Hong Kong. Methods: One hundred and one Chinese patients aged 26–55 years who completed a 3-year territory-wide specialized early intervention service for FEP in Hong Kong were recruited. Assessments encompassing premorbid adjustment, illness onset, clinical, psychosocial and treatment variables were conducted. Patients were categorized into good (n=45) versus poor (n=56) insight based on the ratings on the Scale to Assess Unawareness of Mental Disorder (SUMD). Results: Univariate analyses showed that gender, positive, negative, disorganization and depressive symptoms, self-stigma and general self-efficacy were related to insight (threshold set at p<0.1). Multiple binary logistic regression analysis further revealed that female gender (p=0.004), lower levels of positive (p=0.001) and disorganization (p=0.033) symptoms, more severe depressive symptoms (p=0.007), and greater degrees of self-stigma (p=0.005) were independently associated with good insight status in early psychosis patients. Discussion: Our results highlighted the significant relationships among insight, depression and self-stigma. Prospective research is warranted to clarify the complex longitudinal inter-relationships among these variables in the early stage of illness so as to facilitate development of effective intervention for further outcome improvement in patients with early psychosis.