Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0014
Trends in Psychiatry and Psychotherapy
Original Article

Insight in bipolar disorder: a comparison between mania, depression and euthymia using the Insight Scale for Affective Disorders

O insight no transtorno bipolar: uma comparação entre mania, depressão e eutimia usando a Escala de Insight para Transtornos Afetivos

Rafael de Assis da Silva; Daniel C. Mograbi; Evelyn V. M. Camelo; Jaqueline Bifano; Mayra Wainstok; Luciana Angélica Silva Silveira; Elie Cheniaux

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Abstract

Objective: To evaluate whether having general insight into bipolar disorder and its symptoms is affected by the mood state of the patient, using the Insight Scale for Affective Disorders, a hetero-application scale for people with mood disorders.Methods: Ninety-five patients with bipolar disorder were evaluated and divided into different groups according to the mood state presented during assessment (i.e., euthymia, mania and depression). Sociodemographic and clinical data (Hamilton Depression Scale, Young Mania Rating Scale, and Clinical Global Impressions Scale) were recorded. Insight was evaluated using the Insight Scale for Affective Disorders.Results: Patients with bipolar disorder in mania show less insight about their condition than patients in depression or euthymia, and less insight about their symptoms than patients with depression, with the exception of awareness of weight change.Conclusions: Loss of insight during mania may have important implications for treatment compliance and adherence and needs to be taken into account in the clinical management of people with bipolar disorder.

Keywords

Insight, awareness, bipolar disorder, mania, anosognosia

Resumo

Objetivo: Avaliar se o insight global sobre transtorno bipolar e sobre seus sintomas é afetado pelo estado de humor do paciente, usando a Escala de Insight para Transtornos Afetivos, uma escala de heteroaplicação para pacientes com transtorno do humor.Métodos: Noventa e cinco pacientes com transtorno bipolar foram avaliados e divididos em diferentes grupos de acordo com o estado de humor presente durante a avaliação (i.e., eutimia, mania e depressão). Dados sociodemográficos e clínicos (Escala de Depressão de Hamilton, Escala de Avaliação de Mania de Young e Escala de Impressão Clínica Global) foram registrados. Oinsight foi avaliado usando a Escala de Insight para Transtornos Afetivos.Resultados: Pacientes bipolares em mania apresentaram menor insightsobre sua condição do que pacientes em depressão ou eutimia, e menorinsight sobre seus sintomas do que pacientes em depressão, exceto para consciência de mudança de peso.Conclusões: A perda de insight durante a mania pode ter importantes implicações para aceitação do e aderência ao tratamento e precisa ser levada em conta no manejo clínico de pacientes bipolares.

Palavras-chave

Insight, consciência de morbidade, transtorno bipolar, mania, anosognosia

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