Psychiatric Quarterly

, Volume 90, Issue 2, pp 385–394 | Cite as

Clinical and Cognitive Correlates of Insight in Bipolar Disorder

  • Evelyn Camelo
  • Daniel C. MograbiEmail author
  • Rafael de Assis da Silva
  • Cristina M. T. Santana
  • Rodrigo L. Ferreira do Nascimento
  • Adriana Cardoso de Oliveira e Silva
  • Antônio Egídio Nardi
  • Elie Cheniaux
Original Paper


Insight is greatly impaired in Bipolar Disorder (BD), especially during mania. Cognitive impairment is also present in BD. Despite that, few studies have investigated a possible association between these two aspects. The main goal of the current study is to compare BD affective states regarding performance in cognitive testing and investigate clinical and cognitive predictors for insight loss in BD. The study investigated a sample of 65 patients who were evaluated in one of the BD phases (mania, euthymia or depression). All the subjects underwent neuropsychological evaluation and completed the Insight Scale for Affective Disorders (ISAD). The relationship between level of insight and clinical/cognitive variables was analyzed through multiple regression models. No significant differences were found among BD phases regarding performance on cognitive testing. Insight was more impaired in mania then in depression or euthymia. Predictors for loss of insight were: severity of manic symptoms and impairments in selective attention (Symbol search test), divided attention (Trail making test) and inhibition (Stroop test). The sample size is a potential limitation of the current study. Nevertheless, the results suggest this had limited impact, with group differences being detected for a number of variables. The results found have important clinical importance, suggesting, for example, that rehabilitation of specific cognitive skills may improve insight in BD.


Insight Cognition Bipolar disorder Awareness 


Compliance with Ethical Standards

Conflict of Interest

Evelyn Camelo declares that she has no conflict of interest.

Daniel Mograbi declares that he has no conflict of interest.

Rafael de Assis da Silva declares that he has no conflict of interest.

Cristina M. T. Santana declares that she has no conflict of interest.

Rodrigo L. Ferreira do Nascimento declares that he has no conflict of interest.

Adriana Cardoso de Oliveira e Silva declares that she has no conflict of interest.

Antônio Egídio Nardi declares that he has no conflict of interest.

Elie Cheniaux declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Evelyn Camelo
    • 1
  • Daniel C. Mograbi
    • 2
    • 3
    Email author
  • Rafael de Assis da Silva
    • 1
    • 4
  • Cristina M. T. Santana
    • 1
    • 3
  • Rodrigo L. Ferreira do Nascimento
    • 3
  • Adriana Cardoso de Oliveira e Silva
    • 1
  • Antônio Egídio Nardi
    • 1
  • Elie Cheniaux
    • 1
    • 5
  1. 1.Universidade Federal do Rio de JaneiroRio de JaneiroBrazil
  2. 2.Institute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
  3. 3.Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio)Rio de JaneiroBrazil
  4. 4.Universidade Federal do Estado do Rio de Janeiro (UNIRIO)Rio de JaneiroBrazil
  5. 5.Universidade do Estado do Rio de JaneiroRio de JaneiroBrazil

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