Can cognitive insight predict symptom remission in a first episode psychosis cohort? / O'Connor, Jennifer; Ellett, Lyn; Olesya, Ajnakina; Schoeler, Tabea; Kolliakou, Anna; Trotta, Antonella; Wiffin, Benjamin; Falcone, Aurora; DiForti, Marta; Murray, Robin; Bhattacharyya, Sagnik; David, Tony.

In: BMC Psychiatry, Vol. 17, No. 54, 06.02.2017, p. 1-8.

Research output: Contribution to journalArticlepeer-review



  • Jennifer O'Connor
  • Lyn Ellett
  • Ajnakina Olesya
  • Tabea Schoeler
  • Anna Kolliakou
  • Antonella Trotta
  • Benjamin Wiffin
  • Aurora Falcone
  • Marta DiForti
  • Robin Murray
  • Sagnik Bhattacharyya
  • Tony David


The outcome of first episode psychosis (FEP) is highly variable and difficult to predict. Cognitive insight measured at illness onset has previously been found to predict psychopathology 12-months later. The aims of this study were to examine whether the prospective relationship between cognitive insight and symptom severity is evident at four-years following FEP and to examine some psychological correlates of cognitive insight.

FEP participants (n = 90) completed the Beck Cognitive Insight Scale (BCIS) at illness onset, and associations between BCIS scores with symptom severity outcomes (4-years after FEP) were assessed. The BCIS scales (self-reflectiveness and self-certainty) were examined as a composite score, and individually compared to other cognitive measures (IQ and jumping to conclusions (JTC) bias).

Regression analyses revealed that the cognitive insight composite did not predict 4-year symptom remission in this study while the self-reflection subscale of the BCIS predicted severity of symptoms at 4-years. Self-certainty items of the BCIS were not associated with symptom severity. Significant correlations between the JTC bias, self-certainty and IQ were found, but self-reflection did not correlate with these other cognitive measures.

Self-reflective capacity is a more relevant and independent cognitive construct than self-certainty for predicting prospective symptom severity in psychosis. Improving self-reflection may be a useful target for early intervention research.
Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalBMC Psychiatry
Issue number54
Publication statusPublished - 6 Feb 2017
This open access research output is licenced under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

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