Clinical and Cognitive Correlates of Insight in Bipolar Disorder


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.

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Correspondence to Daniel C. Mograbi.

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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.

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Camelo, E., Mograbi, D.C., de Assis da Silva, R. et al. Clinical and Cognitive Correlates of Insight in Bipolar Disorder. Psychiatr Q 90, 385–394 (2019).

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  • Insight
  • Cognition
  • Bipolar disorder
  • Awareness