Cited by 204Schizophrenia research and treatmentMental Health and PsychiatryBipolar Disorder and Treatment

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The evolution of insight, paranoia and depression during early schizophrenia

DRAKE, R. J., PICKLES, A., BENTALL, R. P., KINDERMAN, P., HADDOCK, G., TARRIER, N., LEWIS, S. W.·2004·Psychological Medicine

DOI 10.1017/s0033291703008821

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Abstract

BACKGROUND: How insight, paranoia and depression evolve in relation to each other during and after the first episode of schizophrenia is poorly understood but of clinical importance. METHOD: Serial assessments over 18 months were made using multiple instruments in a consecutive sample of 257 patients with first episode DSM-IV non-affective psychosis. Repeated measures of paranoia, insight, depression and self-esteem were analysed using structural equation modelling, to examine the direction of relationships over time after controlling for confounds. RESULTS: Depression was predicted directly by greater insight, particularly at baseline, and by greater paranoia at every stage of follow-up. Neither relationship was mediated by self-esteem, although there was a weak association of lower self-esteem with greater depression and better insight. Paranoia was not strongly associated with insight. Duration of untreated psychosis and substance use at baseline predicted depression at 18 months. CONCLUSIONS: In first-episode psychosis, good insight predicts depression. Subsequently, paranoia is the strongest predictor. Neither effect is mediated by low self-esteem. Effective treatment of positive symptoms is important in preventing and treating low mood in early schizophrenia.

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Schoeman, R. (2011) · SUNScholar (Stellenbosch University)
Insight in Schizophrenia: RelaƟ onship to Family History, and PosiƟ ve and NegaƟ ve Symptoms
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Factors predicting the presence of impaired clinical insight in liaison psychiatric patients assessed in the Emergency Room
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Reconhecimento de expressões faciais em pacientes com esquizofrenia e indivíduos não clínicos
Costa, I. R. (2013) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT)
First Episode Psychosis, and the Response thereof to Treatment with Flupenthixol Decanoate
Schoeman, R. (2011)
The insight and the risk of psychiatric re-hospitalization in patients suffering from schizophrenia
Pawelczak, P., Karakuła‐Juchnowicz, H., Wróbel, A., & Stecka, M. (2012) · Current Problems of Psychiatry · doi:10.12923/j.2081-3910/13.4/a.12
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자아존중감과 의심의 상관성 : 정산군, 정신증 고위험군, 최근 발병 조현병군
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Poor insight in obsessive-compulsive disorder: examining the role of cognitive, metacognitive, and neuropsychological variables
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Références
(2015) · Elsevier eBooks · doi:10.1016/b978-2-294-74457-0.00013-6
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(2012) · Elsevier eBooks · doi:10.1016/b978-2-294-72373-5.00012-1

Authors: DRAKE, R. J., PICKLES, A., BENTALL, R. P., KINDERMAN, P., HADDOCK, G., TARRIER, N., & LEWIS, S. W.
Affiliations: University of Manchester (GB)
University of Liverpool (GB)
ORCID: DRAKE, R. J.
PICKLES, A.
BENTALL, R. P.
KINDERMAN, P.
HADDOCK, G.
LEWIS, S. W.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2004-01-28
Volume: 34
Issue: 2
Pages: 285-292
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291703008821
OpenAlex: W2056061093
Cited by: 204
References: 15
Citations by year: 2025: 1 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 4 · 2019: 7 · 2018: 8 · 2017: 5 · 2016: 7 · 2015: 10 · 2014: 18 · 2013: 12 · 2012: 19
FWCI: 8.57
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords: schizophrenia, first-episode psychosis, insight, paranoia, depression, self-esteem, duration of untreated psychosis, substance use, depressive mood
MeSH terms: Adult, Awareness, Depression, Female, Humans, Male, Paranoid Disorders, Predictive Value of Tests, Surveys and Questionnaires, Schizophrenia, Self Concept, Severity of Illness Index, Comorbidity, Incidence, Diagnostic and Statistical Manual of Mental Disorders

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The evolution of insight, paranoia and depression during early schizophrenia

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