Transcultural Insight : A study on insight of immigrant patients with first episode psychosis

Abstract

INTRODUCTION Lack of insight is a key factor in psychotic psychopathology both for its implications and for its frequency. Most researches on the subject, have been conducted in western countries neglecting theinfluence of socio-cultural aspects in its study. OBJECTIVE We aim to determine how cultural factors modulate the capacity of insight in immigrants affected by a fist psychosis episode compared to western patients. MATERIAL AND METHODS We compared insight grade evaluated with Beck Cognitive Insight Scale in two immigrant groups (Western and Non-Western) affected by a first episode psychosis according to clinical feature and severity of symptoms measured by Positive and Negative Syndrome Scale (PANSS). RESULTS We observed statistically significant differences in insight grade between Western and Non-Western groups (p = 0.019). The Western group obtained higher scores in the Self-reflectiveness subscale (R) (p = 0.05) and in the Composite Index (R-C) (p = 0.013) whereas the mean in the Self-Certainty subscale (C) (p = 0.123) was higher in the Non-Western population. Insight grade adjusted by PANSS performance was also examined, showing a statistically significant (r = -0.198) inverse relationship. CONCLUSIONS We believe that cultural perspective should systematically be considered in the evaluation of all patients diagnosed with first episode psychosis and particularly in the evaluation of insight.