Research article

Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study

John A Engh^1,2 , Svein Friis^1,2 , Astrid B Birkenaes^1,2 , Halldóra Jónsdóttir^1,2 , Petter A Ringen^1,2 , Torleif Ruud⁴ , Kjetil S Sundet³ , Stein Opjordsmoen^1,2 and Ole A Andreassen^1,2

¹  Division of Psychiatry, Ulleval University Hospital, Oslo, Norway

²  Institute of Psychiatry, University of Oslo, Norway

³  Institute of Psychology, University of Oslo, Oslo, Norway

⁴  Akershus University Hospital and University of Oslo, Oslo, Norway

author email corresponding author email

BMC Psychiatry 2007, 7:71doi:10.1186/1471-244X-7-71

Published:	11 December 2007

Abstract

Background

Beck Cognitive Insight Scale (BCIS) has been designed for assessment of self-reflection on patients' anomalous experiences and interpretations of own beliefs. The scale has been developed and validated for patients with schizophrenia. We wanted to study the utility of the scale for patients with bipolar disorder. The relationship between the BCIS as a measure of cognitive insight and established methods for assessment of insight of illness was explored in both diagnostic groups.

Methods

The BCIS self-report inventory was administered to patients with schizophrenia (n = 143), bipolar disorder (n = 92) and controls (n = 64). The 15 items of the inventory form two subscales, self-reflectiveness and self-certainty.

Results

The internal consistency of the subscales was good for the patient groups and the controls. The mean subscale scores were not significantly different for the three groups. Four items in subscale self-reflectiveness referring to psychotic experiences gave, however, different results in the control subjects. Self-certainty and scores on insight item PANSS correlated significantly in the schizophrenia, but not in the bipolar group.

Conclusion

BCIS with its two subscales seems applicable for patients with bipolar disorder as well as for patients with schizophrenia. The self-report inventory can also be applied to control subjects if the items referring to psychotic experiences are omitted. In schizophrenia high scores on self-certainty is possibly associated with poor insight of illness. For the bipolar group the subscales are largely independent of traditional insight measures.