Insight as a social identity process in the recovery of psychosocial functioning in the early phase of psychosis
Poster A18, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron
Hannah Klaas1, Alain Clémence, Régis Marion-Veyron, Jean-Philippe Antonietti, Luis Alameda, Philippe Golay, Philippe Conus; 1CHUV, University of Lausanne, Lausanne, Switzerland
Introduction Awareness of illness (insight) has been found to have contradictory effects for recovery in first episode psychosis (FEP). Whereas it is related to psychotic symptom reduction and medication adherence, it is also associated with an increase in depressive symptoms. In this line, the specific effects of insight on recovery over time have not been identified yet, and social indicators of recovery, such as socio-occupational functioning have barely been considered. Drawing from social identity theory we investigated the impact of insight on psychosocial recovery and the interactions of these variables over time. Methods The participants, 240 patients with first episode psychosis from the Treatment and Early Intervention in Psychosis Program (TIPP) of the University Hospital of Lausanne, Switzerland, were assessed at eight time points over three years. Cross-lagged panel analyses and multilevel analyses were conducted on socio-occupational and general functioning (SOFAS and GAF) with insight, time and depressive symptoms as independent variables. Results Results from multilevel analyses point to an overall positive impact of insight on psychosocial recovery, which increases over time. Yet the cross-lagged panel analysis did not reveal a systematic positive and causal effect of insight on SOFAS and GAF scores. Depressive symptoms seem only to be relevant in the beginning of the recovery process. Discussion Our results point to a complex process in which the positive impact of insight on psychosocial functioning increases over time, even when considering depressive symptoms. The procedural aspect of insight should be taken into account in future studies and treatment approaches.
Topic Area: Diagnosis and Phenomenology