The goal of the current study was to examine the relationships between insight and both cognitive function and depression in schizophrenia and schizoaffective disorder, and to determine if there were similar relationships across diagnostic categories. We examined discrepancies between self and informant reports of function on the Specific levels of function scale as a metric of insight for interpersonal, social acceptance, work and activities. We examined two samples of individuals with schizophrenia and/or schizoaffective disorder (Ns of 188 and 67 respectively). In Sample 1, cognition was measured using the Dot Probe Expectancy Task. In Sample 2, cognition was measured by averaging several subtests from the MATRICS consensus cognitive battery, as well as additional measures of working memory. In both samples, depression was measured using the Brief Psychiatric Rating Scale. In both samples, we found significant relationships between worse cognition and overestimations of work function, as well as between higher depression levels and underestimation of interpersonal function. These relationships were specific to interpersonal and work function, with significantly stronger correlations with interpersonal and work function compared to the other areas of function. Similar results were found across diagnostic categories. These results have important implications for treatment planning, as they suggest the need to take into account depression and cognitive function when evaluating the patient's self-report of function, and highlight the utility of informant reports in evaluating function and treatment planning. Further, they add to the literature on the similarity across schizophrenia and schizoaffective disorder in a variety of pathological mechanisms.
Bibliographical noteFunding Information:
JE has no conflicts to report. CSC has received research grants from the National Institutes of Health (NIH), the Brain and Behavior Foundation, the Burroughs Wellcome foundation, GlaxoSmithKline, and the Robert Wood Johnson Foundation and has been an external consultant for Lilly, Merck, Pfizer, Roche, and Servier. JMG has received grants from National Institutes of Health (NIH), receives royalty payments from Brief Assessment of Cognition in Schizophrenia, and has acted as a consultant to Amgen, AstraZeneca, GlaxoSmithKline, Hoffman LaRoche, Merck, Pfizer, and Solvay. AWM has received research grants from the National Institutes of Health (NIH) and the Brain & Behavior Research Foundation. JDR has received research grants from the National Institutes of Health (NIH), the Brain & Behavior Research Foundation, the EJLB Foundation, and the Robert Wood Johnson Foundation. SMS has received research grants from the National Institutes of Mental Health (NIMH), The Brain & Behavior Research Foundation, the van Ameringen Foundation, the Jacob and Valeria Langaloth Foundation, the New England Research Institutes, the New York State Office of Mental Health, the New Jersey Division of Mental Health and Addiction Services, Janssen Pharmaceuticals, AstraZeneca, and Pfizer. MES has no conflicts to report. DMB has received grants from the Brain & Behavior Research Foundation and the National Institutes of Health (NIH), and is a consultant for Pfizer, Amgen, Upsher-Smith and Takeda on studies related to the treatment of negative symptoms in schizophrenia.
© 2017 The Authors