A Comparative Study of Cognitive Insight in Patients with Schizophrenia and Mania with Psychotic Symptoms

Background and Objectives: Insight, a multidimensional entity essential for the treatment of psychotic disorders, is often impaired in schizophrenia and mania with psychotic symptoms. This study compares cognitive insight in patients with these conditions, and its relationship with treatment-related outcomes. Materials and Methods: Conducted over 18 months at Mahatma Gandhi Medical College & Hospital, Jaipur, this prospective observational comparative study included 60 patients (30 with schizophrenia and 30 with mania with psychotic symptoms) selected via purposive sampling. Diagnoses followed ICD-10 criteria, confirmed by two consultant psychiatrists. A semi-structured proforma gathered clinical and socio-demographic data. Cognitive insight was assessed using the Beck Cognitive Insight Scale (BCIS), and psychotic symptoms were evaluated with the Brief Psychiatric Rating Scale (BPRS) and Young Mania Rating Scale (YMRS). Assessments were repeated four weeks after treatment to evaluate insight changes. Statistical analyses used chi-square tests for categorical variables and t-tests for continuous data, with significance at p < 0.05. Results: Schizophrenia patients had a mean age of 30.47 years, while the mania with psychotic symptoms group?s mean age was 32.1 years. The schizophrenia group included more women (53.33%) compared to the mania group, which had more men (80%). Most patients across both groups were educated, Hindu, single, and middle-class. Employment differed significantly, with higher unemployment in the schizophrenia group (53.33%) than in the mania group (26.67%). Both groups showed significant improvements in BPRS, YMRS, and BCIS scores following treatment. Conclusion: This study concludes that patients of schizophrenia and mania with psychotic symptoms differ in cognitive insight. Observed improvements suggest that targeted interventions can effectively enhance cognitive insight.