Author:
Aleman André,Agrawal Niruj,Morgan Kevin D.,David Anthony S.
Abstract
BackgroundOne factor contributing to impaired awareness of illness (poor insight)
in psychotic disorders may be neurocognitive deficits.MethodA systematic review and meta-analysis were conducted after data
extraction. Following an overall analysis, in which measures of different
cognitive domains were taken together, more finegrained analyses
investigated whether there was a specific relation with frontal executive
functioning, and whether this was influenced by diagnosis or the insight
scales used.ResultsThere was a significant mean correlation between insight ratings and
neurocognitive performance (mean weighted r=0.17, 95% CI
0.13–0.21, z=8.3, P < 0.0001), based
on 35 studies with a total of 2354 individuals. Further analyses revealed
that the effect of general intellectual impairment was smaller than the
specific association with executive function. This was only the case for
psychosis in general, and not in an analysis limited to schizophrenia,
where all cognitive domains were associated with impaired insight to a
similar degree.ConclusionsNeuropsychological dysfunction, specifically impairment of set-shifting
and error monitoring, contributes to poor insight in psychosis. Specific
relations with different dimensions of insight and the putative role of
metacognitive functions require further study.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
263 articles.
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