Trajectory of insight on various dimensions among bipolar disorder in-patients

BACKGROUND: Insight is awareness of one's symptoms, illness, and need for treatment. In bipolar disorder, insight is better in bipolar depression and nonpsychotic depression when compared with mania and psychotic depression. Insight impacts on medication adherence. In our study, we measured and compared with various clinical parameters of insight. The aim of this study is to assess various dimensions of insight recovery prospectively in bipolar affective disorder patients with treatment and drug compliance. MATERIALS AND METHODS: Patient's insight was assessed using Mood Disorder Insight Scale (MDIS) at baseline, 1(st), 3(rd), and 6(th) months. Their insight was then compared with various sociodemographic profiles and correlated with number of mood episodes, family history of mental illness, and 6-month MDIS scores. RESULTS: Depression patients scored better in insight components (P = 0.001). The good compliance group attributed their symptoms to their illness than the poor compliance group (P = 0.013). The MDIS scores were gradually improving from baseline to 6 months (P ≤ 0.001). There was no relationship between insight and the number of episodes (P = 0.788). CONCLUSION: Depressive episode patients had better insight during the baseline, which improved during 6 months follow-up compared with manic patients. Among various components of insight, insight on the attribution of symptoms was a predictor of good compliance. Progression of insight was steady and proportionate to the duration of treatment in depressive episode patients.