Exploring the relationship of insight with psychopathology and gender in individuals with schizophrenia spectrum disorde
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ORIGINAL ARTICLE
Exploring the relationship of insight with psychopathology and gender in individuals with schizophrenia spectrum disorders with structural equation modelling Jesus Cobo 1,2,3 & Javier Labad 1,2,3 & Esther Pousa 4 & Lourdes Nieto 3,5 & Susana Ochoa 3,6 & Judith Usall 3,6 & Carles García-Ribera 4 & Iris Baños 6 & Beatriz González 7 & Carmina Massons 1 & Isabel Ruiz 8 & Ada I. Ruiz 3,9 Received: 28 June 2019 / Accepted: 7 April 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract To model the influence of psychopathology on insight deficits in schizophrenia spectrum patients with a genderstratified analysis. Five hundred sixteen patients (65.1% men) with schizophrenia spectrum disorders were evaluated in four centres of the metropolitan area of Barcelona (Catalonia). Psychopathological assessment was performed using different PANSS factors. Insight and its three main dimensions were assessed by means of the Scale of Unawareness of Mental Disorder: awareness of the disease (SUMD-1), of the effect of medication (SUMD-2) and of the social consequences of the disease (SUMD-3). Structural equation models (SEMs) were used to fix the model in the total sample and by gender. Additional analyses included age, duration of illness (DOI) and education status (ES). There were no significant differences between men and women in the three main dimensions of insight. The SEMs in the total sample showed a modest fitting capacity. Fitting improved after a gender-stratified analysis (particularly in women). In men, positive and excited symptoms were associated with poorer insight in all SUMD dimensions, whereas depressive symptoms were associated with better insight. ES in men was also associated with better SUMD-2 or SUMD-3. In contrast, in women, symptoms did not have a negative effect on SUMD-1 or SUMD-2. However, positive symptoms were associated with a poorer SUMD-3, whereas depressive symptoms were associated with better SUMD-3. Moreover, education level was also associated with a better SUMD-3. A gender approach improved the comprehension of the model, supporting the relevance of gender analysis in the study of insight. Keywords Psychosis . Awareness . Positive . Depression . Women
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00737-020-01031-1) contains supplementary material, which is available to authorized users. * Jesus Cobo [email protected] 1
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Mental Health Department. Corporació Sanitària Parc Taulí, Hospital Universitari – UAB – CIBERSAM, Parc Taulí, 1, 08208 Sabadell, Barcelona, Catalonia, Spain Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Catalonia, Spain Research Workgroup on Womens’ Mental Health, Catalan Society of Psychiatry & Mental Health, Barcelona, Catalonia, Spain Servei de Psiquiatria. Hospital Sant Pau, Barcelona, Catalonia, Spain
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Department of Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico D.F., Mexico
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Research an
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