Evidências de Validade de Conteúdo da Beck Cognitive Insight Scale, Versão Brasileira (BCIS-BR) / Content Validity Evidence of the Beck Cognitive Insight Scale Brazilian Version (BCIS) / Evidencia de Validez de Contenido de la Beck Cognitive Insight Scale, Versión Brasileña (BCIS-BR)

O insight cognitivo ou clínico refere-se à capacidade de atribuição de sentido aos sintomas presentes em transtornos psicóticos, especialmente naqueles relacionados ao espectro da esquizofrenia. A Beck Cognitive Insight Scale (BCIS) foi desenvolvida com a finalidade de auxiliar o tratamento de pessoas com o insight comprometido. No entanto, este instrumento ainda não foi devidamente adaptado ao contexto brasileiro. Este estudo teve como objetivo fazer a adaptação transcultural da BCIS para o português do Brasil por meio da evidência de validade de conteúdo. Seis juízes avaliaram os itens desta escala quanto à clareza da linguagem, pertinência prática, relevância teórica e relação item-dimensão. A BCIS apresentou concordância satisfatória nos índices de validade de conteúdo e homogeneidade das respostas referente à análise da clareza da linguagem, pertinência prática e relevância teórica e concordância entre item-dimensão teórica, com reformulação de alguns itens. A retrotradução da escala recebeu aval positiva de uma das autoras originais. No entanto, ainda é necessária a verificação das propriedades psicométricas desta versão da BCIS.

Cognitive or clinical insight refers to the ability to assign meaning to symptoms present in psychotic disorders, especially those related to the schizophrenia spectrum. The Beck Cognitive Insight Scale (BCIS) was developed to support the treatment of people with impaired insight. However, this instrument has not yet been adapted to the Brazilian context. This study aimed to make the cross-cultural adaptation of the BCIS into Brazilian Portuguese through evidence of content validity. Six judges evaluated the items of this scale regarding clarity of language, practical relevance, theoretical relevance and item-dimension relatedness. The BCIS presented satisfactory agreement in the indices of content validity and homogeneity of responses regarding the analysis of clarity of language, practical relevance and theoretical relevance and agreement between item-theoretical dimension, reformulating some items. The back-translation of the scale received a positive endorsement from one of the original authors. However, it is still necessary to verify the psychometric properties for this version of the BCIS.

El insight cognitivo o clínico se refiere a la capacidad de asignar un significado a los síntomas presentes en los trastornos psicóticos, especialmente aquellos relacionados con el espectro de la esquizofrenia. La Escala de Insight Cognitivo de Beck (BCIS) fue desarrollada para apoyar el tratamiento de personas con insight comprometido. Sin embargo, este instrumento todavía no ha sido adaptado al contexto brasileño. Este estudio tuvo como objetivo realizar la adaptación transcultural de la BCIS al portugués brasileño mediante pruebas de validez de contenido. Seis jueces evaluaron los ítems de esta escala en cuanto a la claridad del lenguaje, la relevancia práctica, la relevancia teórica y la relación ítem-dimensión. La BCIS presentó una concordancia satisfactoria en los índices de validez de contenido y homogeneidad de respuestas en cuanto al análisis de la claridad del lenguaje, relevancia práctica y relevancia teórica, y concordancia entre ítem-dimensión teórica, reformulando algunos de los ítems. La retraducción de la escala recibió una aprobación positiva de una de las autoras. Todavía es necesario verificar las propiedades psicométricas de esta versión de la BCIS.

An Observational Study Of Clinical Profile And Cognitive Insight In Patients Of Treatment Resistant Schizophrenia

Objectives -It has been estimated that 20-50% patients with Schizophrenia can develop treatment resistance. Treatment resistance is associated with increased morbidity in these patients and it also increases the burden for the caretakers. Very few Indian studies have tried to establish the factors associated with resistance in Schizophrenia. Hence, this study was conducted to identify the socio-demographic profile, illness variables, co-morbidities and cognitive insight in patients with Treatment Resistant Schizophrenia. Methodology: The study was conducted after permission from Institutional Ethics Committee. 50 consecutive patients of Treatment Resistant Schizophrenia (treated with 2 antipsychotics from different classes with adequate doses for 6 weeks each and currently satisfying the DSM IV TR criteria for Schizophrenia) were included in the study. Patients were administered a semi-structured questionnaire to obtain details about sociodemographic status, age of onset, family history, number of episodes and treatment received. DSM-IV-TR was used to identify psychiatric comorbidities. Becks cognitive insight scale was used to assess cognitive insight. Results: The mean age of patients in the study with Treatment Resistant Schizophrenia (TRS) was found to be 33.5yrs with M: F ratio of 1.77:1. It was found that 34% of patients had an onset before 20 yrs of age. Positive family history of mental illness was present in 48% of the TRS patients. Multiple episodes (>5) were present in 36% of patients. TRS was characterized by absence of affective symptoms in 90% of patients. On applying Beck's cognitive insight scale, patients of TRS were found to have higher Self-Certainty score as compared to Self-Reflection, indicating poor awareness into their illness and treatment. Conclusions: It is important to identify Schizophrenia patients with early age of onset, positive family history, absence of affective features and poor cognitive insight to improve the long-term course of Schizophrenia

The Characteristics of Bipolar Outpatients in Remission Showing False-Negatives on the Korean Version of Mood Disorder Questionnaire / 신경정신의학

OBJECTIVES: The Mood Disorder Questionnaire (MDQ) has been validated as a diagnostic screening instrument for the detection of patients with bipolar disorder, but some patients with bipolar disorder obtain false negative screens. So we investigated demographic and clinical characteristics in false-negative MDQ in bipolar patients. METHODS: The participants were 60 DSM-IV bipolar outpatients in remission. All completed the Korean version of the Mood Disorder Questionnaire (K-MDQ) and the Korean version of the Beck Cognitive Insight Scale (K-BCIS) and were assessed by a trained clinician on the Young Mania Rating Scale, the Hamilton Depression Rating Scale and the Global Assessment of Functioning scale. The patients were categorized into two groups according to their K-MDQ score excluding further two questions (MDQ > or =7 : K-MDQ-positives and MDQ <7 : K-MDQ-negatives). Differences in demographic and clinical characteristics between these two groups were analyzed. RESULTS: There were no statistically significant differences between K-MDQ-positives and K-MDQ-negatives on the demographic and clinical variables, except on the K-BCIS where K-MDQ-negatives reported significantly lower scores on the K-BCIS composite index and self-reflectiveness subscale. CONCLUSION: These results suggest that lack of insight is a confounding factor in screening for bipolar disorder using the K-MDQ.