Journal of Affective Disorders
Volume 91, Issue 1 , Pages 1-9, March 2006

Insight, symptoms and neurocognition in bipolar I patients

  • M. Varga

      Affiliations

    • Department of Neuropsychology and Rehabilitation, Ulleval University Hospital, 0407 Oslo, Norway
    • Corresponding Author InformationCorresponding author. Tel.: +47 23033383/+47 91346194; fax: +47 23033399.
    • ,
  • A. Magnusson

      Affiliations

    • Department of Psychiatry, Aker University Hospital, 0514 Oslo, Norway
    • ,
  • K. Flekkøy

      Affiliations

    • Department of Neuropsychology and Rehabilitation, Ulleval University Hospital, 0407 Oslo, Norway
    • ,
  • U. Rønneberg

      Affiliations

    • Ryen District Psychiatric Clinic, 0679 Oslo, Norway
    • ,
  • S. Opjordsmoen

      Affiliations

    • Department of Psychiatry, Ulleval University Hospital, 0407 Oslo, Norway

Received 1 April 2005; received in revised form 31 August 2005; accepted 5 September 2005.

Abstract 

Background

Level of insight and its relationship to clinical variables and neurocognitive functions was assessed in bipolar I patients.

Methods

Verbal memory, executive functioning, sustained attention, general intelligence and other neurocognitive functions were compared between 37 chronic in- and outpatients and 31 matched normal controls. Detailed psychiatric interviews were completed to define the level of symptomatology and psychosocial functioning. Insight was assessed by the Scale to Assess Unawareness of Mental Disorder (SUMD).

Results

Seventy percent of the patients were classified as having impaired insight. Prevalence of impaired insight was 47% and 94% in remitted and symptomatic patients, respectively. Symptomatic patients scored significantly below remitted patients on insight and neurocognition. Illness and symptom unawareness were related to overall level of symptoms, measures of memory, conceptual ability and right hand psychomotor speed and accuracy. Misattribution of symptoms and signs was correlated to visuomotor speed and visuospatial performance in addition to affective symptoms and thought disturbance.

Conclusions

Our findings support the hypothesis that impaired insight and other neurocognitive dysfunctions were present in a large percentage of cases among symptomatic as well as remitted bipolar patients. This may be of clinical relevance and raises important questions about the course and outcome of the illness.

Keywords: Bipolar disorder, Insight, Awareness, Neuropsychological tests

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PII: S0165-0327(05)00285-5

doi:10.1016/j.jad.2005.09.002

Journal of Affective Disorders
Volume 91, Issue 1 , Pages 1-9, March 2006

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