Insight in bipolar disorder: associations with cognitive and emotional processing and illness characteristics

Marieke van der Werf - Eldering, Lisette van der Meer*, Huibert Burger, Esther Holthausen, W.A. Nolen, Andre Aleman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

31 Citations (Scopus)

Abstract

Objective: To investigate the multifactorial relationship between illness insight, cognitive and emotional processes, and illness characteristics in bipolar disorder patients.

Methods: Data from 85 euthymic or mildly to moderately depressed bipolar disorder patients were evaluated. Insight was measured using the Mood Disorder Insight Scale (total score and subscale scores: awareness of illness, symptom attribution, and need for treatment). Cognitive and emotional functioning was measured in four domains (processing speed, memory, executive functioning, and emotional learning) in addition to premorbid IQ. Illness characteristics were assessed using the Mini-International Neuropsychiatric Interview, the Questionnaire for Bipolar Disorder, and the Inventory of Depressive Symptomatology-self rating scale. Regression analyses were performed for the whole sample. Post-hoc, interactions with lifetime psychotic features (LPF) were statistically tested and if significant, analyses were repeated for patients with (n = 36) and without (n = 49) LPF separately.

Results: In the whole group, better insight was associated with lower processing speed, better memory performance, increased emotional learning, higher level of depressive symptoms, and longer duration of illness. Patients with LPF had worse awareness of illness, but better symptom attribution than patients without LPF. No group differences for need for treatment and overall insight were found. Finally, processing speed significantly predicted subscores for symptom attribution in patients with LPF only.

Conclusions: Cognitive functioning as well as impairments in emotional learning and psychotic features independently contributes to impaired insight in bipolar disorder. Processing speed seems to be a key variable in the prediction of insight in patients with LPF and not in patients without LPF.

Original languageEnglish
Pages (from-to)343-354
Number of pages12
JournalBipolar Disorders
Volume13
Issue number4
DOIs
Publication statusPublished - Jun-2011

Keywords

  • awareness
  • bipolar disorder
  • clinical characteristics
  • cognition
  • depression
  • emotional learning
  • insight
  • mood disorders
  • REPORT QIDS-SR
  • I DISORDER
  • DEPRESSIVE SYMPTOMATOLOGY
  • MOOD DISORDERS
  • NEUROPSYCHOLOGICAL FUNCTION
  • 1ST-EPISODE SCHIZOPHRENIA
  • PSYCHOMETRIC EVALUATION
  • EUTHYMIC PATIENTS
  • SOCIAL COGNITION
  • QUICK INVENTORY

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