A Comparitve study of insight between patients with schizophrenia and mania with psychosis

BACKGROUND: Impaired awareness of one’s own illness has been known for hundreds of years. Many studies report that approximately more than half of the schizophrenia patients have moderate to severe impairment in their awareness of illness and approximately 40% of patients with Bipolar disorder have impaired awareness of illness. Studies also suggest that approximately one-third of schizophrenic patients improved in their insight when they take antipsychotic medications and also larger percentage of insight improvement occurs in patients with bipolar affective disorder- Mania with Psychotic symptoms on medications. AIM OF THE STUDY: 1. To measure the prevalence of insight in schizophrenia and mania with psychosis. 2. To find relationship between severity of psychosis and insight. 3. To find relationship between insight and overall functioning. 4. To study the change that occurs in insight during hospitalization and treatment. 5. To analyze insight deficits between schizophrenia and mania with psychosis. MATERIALS AND METHODS: This is a descriptive cross sectional study done in patients admitted in psychiatry ward, Thanjavur Medical College Hospital, Thanjavur. Study sample was collected by using purposive nonprobabality sampling method by which patients who fulfiled the ICD-10 criterea of Schizophrenia and who filled the ICD-10 criteria of Bipolar disorder Mania with Psychotic symptoms were included in this study. The study period was between February 2016 – July 2016. Instruments: 1. A Semi structured Proforma for social demographic variables. 2. Brief Psychiatric Rating Scale (BPRS). 3. Young Mania Rating Scale (YMRS). 4. Global Assessment of Functioning scale (GAF). 5. Schedule for the Assessment of Insight-Expanded version (SAI-E). Above scales are administered twice, first at the time of admission and again at the time of discharge. During the stay in hospital, the patients were treated mainly by the Biological methods (Psychotropic drugs like Antipsychotics, Mood stabilizers and Benzodiazepines). Based on the collected information, both groups are compared and analyzed. RESULTS: Of 30 schizophrenia patients 75% and of 30 mania with psychosis patients 72.4% had poor insight at the time of admission and the mean age of onset of schizophrenia was found to be 28.6 and for mania with psychosis 33. On comparing insight at admission and at discharge in both groups have shown insight improvement occur during discharge period. There was a negative correlation was seen between the severity of psychotic symptoms and insight and also a positive correlation was seen between insight improvement and their functioning level in both groups. Schizophrenia patients were less employed than mania with psychosis patients. CONCLUSION: This study gives us an insight into an insight and an importance of insight for regular drug compliance and psychosocial functioning. No statistical significant difference in mean insight was seen between the two groups. Medications improve psychotic symptoms and an insight in both the groups.