Comparison of three scales (BIS, SUMD and BCIS) for measuring insight dimensions and their evolution after one-year of follow-up: Findings from the FACE-SZ Cohort.
Psychiatry Research. 2021-09-01; 303: 114044
DOI: 10.1016/j.psychres.2021.114044
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1. Psychiatry Res. 2021 Sep;303:114044. doi: 10.1016/j.psychres.2021.114044. Epub
2021 Jun 20.
Comparison of three scales (BIS, SUMD and BCIS) for measuring insight dimensions
and their evolution after one-year of follow-up: Findings from the FACE-SZ
Cohort.
Capdevielle D(1), Norton J(2), Aouizerate B(3), Berna F(4), Chereau I(5),
D’Amato T(6), Dubertret C(7), Dubreucq J(8), Fond G(9), C L(10), Mallet J(7),
Misdrahi D(11), Passerieux C(12), Rey R(6), Schurhoff F(13), Urbach M(12),
Llorca PM(5), Raffard S(14); FACE-SCZ Group.
Collaborators: Aouizerate B(15), Berna F(16), Blanc O(17), Capdevielle D(18),
Chereau-Boudet I(17), Coulon N(19), D’Amato T(20), Dorey JM(20), Dubertret
C(21), Fond G(22), Gabayet F(23), Lacelle D(17), Lançon C(24), Laouamri H(25),
Leboyer M(26), Llorca PM(17), Mallet J(21), Metairie E(24), Misdrahi D(27),
Passerieux C(28), Pignon B(26), Peri P(24), Portalier C(21), Rey R(20), Roman
C(23), Schürhoff F(26), Szöke A(26), Urbach M(28), Zinetti-Bertschy A(16).
Author information:
(1)Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie
Adulte, Hôpital la Colombière, CHU Montpellier, Montpellier, France; IGF, Univ.
Montpellier, CNRS, INSERM, Montpellier, France. Electronic address:
.
(2)University of Montpellier, Institute for Neurosciences of Montpellier (INM),
INSERM, Montpellier, France.
(3)Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens,
Université de Bordeaux, F-33076 Bordeaux, France; Bordeaux Sleep Clinique,
Pellegrin University Hospital, Bordeaux University, USR CNRS 3413 SANPSY,
Research Unit, 33000 Bordeaux, France; Inserm, Neurocentre Magendie,
Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France.
(4)Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de
Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine
Translationnelle de Strasbourg, Strasbourg, France.
(5)Fondation FondaMental, Créteil, France; Clermont-Ferrand University Hospital,
EA 7280 Auvergne University, BP 69 63003 Clermont-Ferrand Cedex 1, France.
(6)Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de
Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe
PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678
Bron Cedex, France.
(7)Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry,
Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot,
Sorbonne Paris Cité, Faculté de médecine, France.
(8)Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation
Psychosociale, CH Alpes Isère, Grenoble, France.
(9)Fondation FondaMental, Créteil, France; AP-HM, la Conception Hospital,
Aix-Marseille Univ, School of medicine – La Timone Medical Campus, EA 3279:
CEReSS – Health Service Research and Quality of Life Center, 27 Boulevard Jean
Moulin, 13005 Marseille, France.
(10)Fondation FondaMental, Créteil, France; Pôle psychiatrie universitaire, CHU
Sainte-Marguerite, F-13274 Marseille cedex 09, France.
(11)Fondation FondaMental, Créteil, France; Department of Adult Psychiatry,
Charles Perrens Hospital, F-33076 Bordeaux; University of Bordeaux, CNRS UMR
5287-INCIA, Bordeaux, France.
(12)Fondation FondaMental, Créteil, France; Service de psychiatrie d’adulte,
Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil,
Université Versailles Saint-Quentin en Yvelines, Versailles, France.
(13)Fondation FondaMental, Créteil, France; INSERM U955, Translational
Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et
d’Addictologie des Hôpitaux Universitaires Henri Mondor, Paris Est University,
40 rue de Mesly, 94000 Créteil, France.
(14)Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHU
Montpellier, Montpellier, France; Univ Paul Valéry Montpellier 3, Univ.
Montpellier, EPSYLON EA, Montpellier, France.
(15)Fondation Fondamental; Department of Adult Psychiatry, Charles Perrens
Hospital, F-33076 Bordeaux, France; Laboratory of Nutrition and Integrative
Neurobiology (UMR INRA 1286), University of Bordeaux, France.
(16)Fondation Fondamental; Strasbourg University Hospital, University of
Strasbourg, INSERM U1114, Federation of Translational Psychiatry, Strasbourg,
France.
(17)Fondation Fondamental; Clermont-Ferrand University Hospital, EA 7280
Auvergne University, BP 69 63003 Clermont-Ferrand Cedex 1, France.
(18)Fondation Fondamental; IGF, Univ. Montpellier, CNRS, INSERM, CHU
Montpellier, Montpellier, France.
(19)Fondation Fondamental; INSERM U955, Translational Psychiatry Team, DHU
Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d’Addictologie des
Hôpitaux Universitaires Henri Mondor, Paris Est University, 40 rue de Mesly,
94000 Créteil, France; Psychosocial Rehabilitation Reference Center and
Schizophrenia Expert Center, Alpes Isère Hospital, Grenoble, France.
(20)Fondation Fondamental; INSERM, U1028; CNRS, UMR5292; University Lyon 1; Lyon
Neuroscience Research Center, PSYR2 Team; le Vinatier Hospital, Schizophrenia
Expert Centre, Lyon, F-69000, France.
(21)Fondation Fondamental; AP-HP ; Department of Psychiatry, Louis Mourier
Hospital, Colombes, France ; Inserm UMR1266, Institute of Psychiatry and
Neuroscience of Paris, University Paris Descartes, France; Université Paris
Diderot, Sorbonne Paris Cité, Faculté de médecine, France.
(22)Fondation Fondamental; AP-HM, la Conception Hospital, Aix-Marseille Univ,
School of medicine – La Timone Medical Campus, EA 3279: CEReSS – Health Service
Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille,
France.
(23)Fondation Fondamental; Psychosocial Rehabilitation Reference Center and
Schizophrenia Expert Center, Alpes Isère Hospital, Grenoble, France.
(24)Fondation Fondamental; Department of Psychiatry (AP-HM), Sainte-Marguerite
University Hospital, Marseille, France.
(25)Fondation Fondamental.
(26)Fondation Fondamental; INSERM U955, Translational Psychiatry Team, DHU
Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d’Addictologie des
Hôpitaux Universitaires Henri Mondor, Paris Est University, 40 rue de Mesly,
94000 Créteil, France.
(27)Fondation Fondamental; Department of Adult Psychiatry, Charles Perrens
Hospital, F-33076 Bordeaux; University of Bordeaux, CNRS UMR 5287-INCIA,
Bordeaux, France.
(28)Fondation Fondamental; Department of Adult Psychiatry, Versailles Hospital,
Le Chesnay, France ; HandiRESP Laboratory, EA4047, UFR Health Sciences Simone
Veil, Université de Versailles Saint-Quentin-En-Yvelines,
Montigny-le-Bretonneux, France.
The aim of our study was to compare the performance of three different
instruments measuring clinical and cognitive dimensions of insight. Data on 182
outpatients with schizophrenia and one-year follow-up assessments was drawn from
the FACE-SZ cohort. Awareness of clinical state (« clinical insight ») was
measured using both a clinician-rated measure (the Scale to assess Unawareness
of Mental Disorder (SUMD)), and a self-report measure (the Birchwood Insight
Scale (BIS). Cognitive insight was measured using a self-report measure (the
Beck Cognitive Insight Scale (BCIS)). For each scale, change in insight was
examined at the follow-up. Correlations between SUMD and BIS subscales measuring
same dimensions were significant. BIS-BCIS correlations were weak for all
combinations except between BIS illness dimension and BCIS composite score. At
the follow-up, BIS and SUMD awareness of treatment need improved whereas illness
and symptom awareness increased only on the SUMD. Conversely, cognitive insight
composite scores decreased. Despite relatively good overall agreement between
the two clinical insight instruments, considerable variability for similar
insight dimensions measured by different instruments was found. Agreement
between cognitive and clinical insight is moderate. Our study strengthens the
argument that insight is harder to operationalize than other symptoms and may
explain why it is so seldom explicitly targeted in schizophrenia treatment.
Copyright © 2021. Published by Elsevier B.V.
DOI: 10.1016/j.psychres.2021.114044
PMID: 34161854 [Indexed for MEDLINE]