Insight in bipolar disorder
While the relationship between lack of insight in psychiatric disorders and anosognosia in neurological disorders has not been extensively studied, interest in examining psychiatric lack of insight has roots in advances in the understanding of the anosognosia. It is possible that both conditions share a common etiology in parietal and/or frontal lobe dysfunction, or they may represent two distinct entities with different etiologies, i.e., with predominance of brain dysfunction in anosognosia as opposed to the possible prominence of psychosocial factors in psychiatric lack of insight.
While it has long been recognized that insight is impaired in schizophrenia and other psychotic disorders, the topic of insight in bipolar disorder has been relatively neglected. In mania, impairment of insight is about as severe as in schizophrenia and probably is associated with poor prognosis. The neuropsychological and/or psychosocial roots of lack of insight in mania remain unclear even if we recently reported that lack of insight might predict impaired decision-making in manic patients. In bipolar depression, impairment of insight is less severe than in mania; however, psychotic depression is associated with less insight than non-psychotic depression. There is some evidence that insight in depression may be less impaired when depressive symptoms are more severe, possibly supporting the depressive realism hypothesis. In remission, bipolar patients seem to recover insight. Thus, lack of insight in bipolar disorder appears to be a state-related phenomenon, unlike schizophrenia.
Interest in studying clinical, neuropsychological and biological roots of insight in bipolar disorder, and their changes across different phases of illness, may improve our understanding of mechanisms underlying awareness of well-being in human.
Conference:
2nd NEUROMED Workshop, Fez, Morocco, 10 Jun - 12 Jun, 2010.
Presentation Type:
Oral Presentation
Topic:
Oral Session 1: Brain diseases and their treatment
Citation:
(2010). Insight in bipolar disorder.
Front. Neurosci.
Conference Abstract:
2nd NEUROMED Workshop.
doi: 10.3389/conf.fnins.2010.12.00009
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Received:
03 Jun 2010;
Published Online:
03 Jun 2010.