A comparative study evaluating insight in different phase of illness among patients with bipolar disorder by using multiple scales

Abstract

Aim

This cross-sectional study aimed to evaluate insight and its correlates among patients with bipolar disorder (BD).

Methodology

180 patients with BD were evaluated on Scale to Assess Unawareness of Mental Disorders (SUMD), Insight scale for affective disorders (ISAD), Mood Disorders Insight Scale (MDIS), and Beck Cognitive Insight Scale (BCIS).

Results

About half of the patients were in clinical remission (N = 94; 52.2%), one-fifth (N = 37; 20.55%) were in the phase of mania and one-fourth (N = 49; 27.2%) were in a depression. There was no significant difference in the level of insight between those in clinical remission and those in depression except for one of the domains of BCIS. Patients with mania had poorer insight compared to those in remission and depression. In terms of association of insight as assessed by different scales, in the whole sample and all the three subgroups, SUMD current and past scores had a significant positive correlation with the ISAD total score. In the whole sample, among patients currently in remission and those currently in depression, ISAD total score had significant negative correlation with MDIS total score. Poorer insight as assessed on SUMD (current and past), ISAD and MDIS was associated with poorer medication adherence.

Conclusion

The present study demonstrates that patients with mania have poor insight when compared to the patients in clinical remission and depression. The present study also demonstrates that the assessment of clinical insight is not affected much by the type of scale used.

Keywords:

• Bipolar disorder
• insight
• medication adherence

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Shinjini Choudhury

Shinjini Choudhury, has done MD, Psychiatry and is currently pursuing DM in Addiction Medicine.

Ajit Avasthi

Ajit Avasthi, Professor and Former Head of the Department, at PGIMER, Chandigarh. His area of interest is affective disorders and he has more than 400 publications.

Subho Chakrabarti

Subho Chakrabarti, MD, MRCPsych, Professor, Department of Psychiatry, PGIMER, Chandigarh. His area of interest is Bipolar disorder and caregivers of persons with severe mental disorders; he has more than 400 publications to his credit.

Sandeep Grover

Sandeep Grover, MD, Professor, Department of Psychiatry, PGIMER, Chandigarh. His area of interest is Affective disorders, Consultation-Liaison Psychiatry and caregivers of persons with severe mental disorders; he has more than 600 publications to his credit.