Patients’ insight, knowledge of psychotic symptoms aid functional remission
MedWire News: Patients with psychotic symptoms who have good insight into their illness, are knowledgeable of warning signs and drug treatments, and employ good coping strategies tend to have good treatment outcomes, a naturalistic study suggests.
The study “emphasizes the importance of cognitive enhancements and specific teachings to patients not in functional remission to enable them to better deal with and understand their treatments, their illness, and its consequences,” say Malin Alenius (Uppsala University, Sweden) and colleagues in the journal Social Psychiatry and Psychiatric Epidemiology.
The researchers used patient interviews and information gathered from patient drug charts to investigate the knowledge and insight in relation to treatment response in all patients at the Psychosis Outpatient Care Clinic of Jönköping in Sweden.
Using the CANSEPT classification method, the researchers divided the patients into those who were in functional remission (n=38) and those who were not (n=78).
The two groups did not differ significantly in their awareness of their psychiatric symptoms and the number who knew their correct diagnosis.
However, the SPKS knowledge of illness and drugs rating scale showed that 37% of patients in functional remission had insight into the association between their symptoms and their current diagnosis, compared with just 10% of patients not in functional remission – a statistically significant difference.
Moreover, the warning signs preceding worsening of psychosis were recognized by 50% of patients in functional remission, compared with just 26% of non-functional remission patients.
The researchers note that a similar percentage of patients in each group knew how to react to warning signs, but a significantly higher proportion of patients in the non-functional remission group had no strategy on how to react to warning signs, at 23% compared with 8% of patients in the functional remission group.
A similar, but nonsignificant, trend was seen for residual symptoms.
Only 45% of patients knew the name or the dosage of their drugs, and a significantly higher proportion of those who knew both were in the functional remission group, at 61% versus 41% of patients not in functional remission.
Those in functional remission were also more likely than patients not in functional remission to know the advantages of taking their prescribed drugs.
“Our study points to the lack of knowledge and insight displayed by many patients who are not in functional remission,” say Alenius and co-workers.
“This lack of knowledge and insight may considerably affect a person’s autonomy and sense of meaning.”
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By Lucy Piper