ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2020
The association between insight and depressive symptoms in schizophrenia: Undirected and Bayesian network analyses.
Article in European psychiatry : the journal of the Association of European Psychiatrists, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Self-stigma in schizophrenia: a systematic review and meta-analysis of 37 studies from 25 high- and low-to-middle income countries.Molecular psychiatry · 2023Pooled it
- Changes in insight and outcome over the early course of first-episode psychosis. The OPTiMiSE trial.Schizophrenia research. Cognition · 2026Article
- Multifactorial associations of non-suicidal self-injury among adolescents with depression: a network analytic perspective.BMC psychology · 2026Article
- A symptom network approach to schizophrenia in the CATIE study: processing speed as the central cognitive impairment.BJPsych open · 2026Article
- Insight Paradox in Patients With Schizophrenia: A Concept Analysis.International journal of mental health nursing · 2025Review
- Gender Differences in Psychosocial Pathways to Depression and Anxiety: Cross-Sectional and Bayesian Causal Network Study.Journal of medical Internet research · 2025Article
- Gender differences in the interactions and inferred causal relationships between risk factors and gaming disorder: a network and structural equation modeling approach.European archives of psychiatry and clinical neuroscience · 2025Article
- The awareness, characterization, and burden of Cognitive Impairment Associated with Schizophrenia (CIAS) in clinical practice: Results from a nationwide survey in Italy.Schizophrenia research. Cognition · 2025Article
- Elucidating the relationship between burnout and sleep disturbances among firefighters: a network analysis.BMC public health · 2025Article
- Interrelationships Among Personality Traits, Depressive Symptoms, Childhood Abuse, and Social Disability.Depression and anxiety · 2025Article
- Insight and suicidality in first-episode psychosis: The mediating role of depression.Schizophrenia research · 2025Article
- Mapping Connection and Direction Among Symptoms of Sleep Disturbance and Perceived Stress in Firefighters: Embracing the Network Analysis Perspective.Nature and science of sleep · 2025Article
- Ketamine-assisted group psychotherapy integrating cognitive processing therapy to address identity-based trauma: a pilot study.Frontiers in psychiatry · 2025Article
- Sex differences in the association between suicidal ideation and neurocognitive function in Chinese patients with schizophrenia.European archives of psychiatry and clinical neuroscience · 2024Article
- Major Depressive Disorder with Catatonia: A Phenotype Related to Autistic Traits and High Suicidality.Journal of clinical medicine · 2024Article
- Depressive Symptoms among Psychiatric Nurses in a Hospital: An Analytical Research.Actas espanolas de psiquiatria · 2024Article
- Implications of Social Anxiety Symptoms in Adults with Autism Spectrum Disorder: Is There a Predictive Role of Interpersonal Sensitivity and Substance Abuse?Brain sciences · 2023Article
- Effects of Bullying on Anxiety, Depression, and Posttraumatic Stress Disorder Among Sexual Minority Youths: Network Analysis.JMIR public health and surveillance · 2023Article
- The Relationship Between Suicidal Behavior, Neurocognitive Functions, and Insight in Patients with Schizophrenia.Psychiatry and clinical psychopharmacology · 2023Article
- Associations Between Clinical Insight and History of Severe Violence in Patients With Psychosis.Schizophrenia bulletin open · 2023Article
Corrections and comments
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Authors and funding
29 authors at 19 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGreater levels of insight may be linked with depressive symptoms among patients with schizophrenia, however, it would be useful to characterize this association at symptom-level, in order to inform research on interventions.
methodsData on depressive symptoms (Calgary Depression Scale for Schizophrenia) and insight (G12 item from the Positive and Negative Syndrome Scale) were obtained from 921 community-dwelling, clinically-stable individuals with a DSM-IV diagnosis of schizophrenia, recruited in a nationwide multicenter study. Network analysis was used to explore the most relevant connections between insight and depressive symptoms, including potential confounders in the model (neurocognitive and social-cognitive functioning, positive, negative and disorganization symptoms, extrapyramidal symptoms, hostility, internalized stigma, and perceived discrimination). Bayesian network analysis was used to estimate a directed acyclic graph (DAG) while investigating the most likely direction of the putative causal association between insight and depression.
resultsAfter adjusting for confounders, better levels of insight were associated with greater self-depreciation, pathological guilt, morning depression and suicidal ideation. No difference in global network structure was detected for socioeconomic status, service engagement or illness severity. The DAG confirmed the presence of an association between greater insight and self-depreciation, suggesting the more probable causal direction was from insight to depressive symptoms.
conclusionsIn schizophrenia, better levels of insight may cause self-depreciation and, possibly, other depressive symptoms. Person-centered and narrative psychotherapeutic approaches may be particularly fit to improve patient insight without dampening self-esteem. •Better insight seems associated with depressive symptoms in schizophrenia.•Network analyses were used to explore this association in a large sample.•Insight was associated with self-depreciation, guilt, and suicidal ideation.•Although cross-sectional, data suggest causal direction from insight to depression.
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