Clinical Psychiatry News Digital Network January 20, 2016
Schizophrenia patients with less insight into their symptoms had thinner cortical thickness in the right insular cortex than did patients with greater insight, according to Seema Emami and associates.
[Both insulas – but the right especially – are known to be where the brain “perceives” incoming sensory information.]
Ms. Emami recruited 67 patients aged 18-50 with schizophrenia from clinics at the Douglas Mental Health University Institute in Montreal. The patients were assessed using two instruments – the Scale for Assessment of Positive Symptoms and the Scale for the Assessment of Insight – Expanded. Cortical thickness data were assessed using MRI.
Compared with a healthy control group, schizophrenia patients with less insight into symptoms (IS) had thinner right insular cortex than patients with greater IS. Patients with greater IS showed “cortical thickness differences only in the right inferior temporal cortex and right anterior cingulate gyrus,” the investigators wrote.
No difference between patient groups was found in the frontal lobe region or the superior temporal gyrus on either hemisphere. Small correlations were observed between illness insight and thinner cortex in the right parahippocampal gyrus, and in awareness of need for treatment and thinner cortex in the left cuneus and right parahippocampal gyrus.
[The front lobe and superior temporal gyrus are known the be the impulsivity and behavioral control centers of the brain.]
“Better measurement and understanding of symptom awareness, as well as development of insight remediation therapies, may aid clinicians in improving therapeutic cooperation and contribute to reduced treatment noncompliance,” the investigators noted.
What is significant is that PET and MRI scan-based research have shown that psych patients of all kinds – including those in the psychotic spectrum that includes sz, sza, szt and bipolar – show growth in the all three of these areas when they participate in CBT- and MBCT-style psychotherapy. Further, the last four psychotherapies listed immediately below can be expected to have substantial impact upon neuronal growth and function in the right insular cortex.
REBT – https://en.wikipedia.org/wiki/Rational_emotive_behavior_therapy
Schematherapy – https://en.wikipedia.org/wiki/Schema_Therapy
Learned Optimism – https://en.wikipedia.org/wiki/Learned_optimism
Standard CBT – https://www.nami.org/Learn-More/Treatment/Psychotherapy & scroll down
DBT – http://behavioraltech.org/resources/whatisdbt.cfm
MBSR – http://www.mindfullivingprograms.com/whatMBSR.php
MBCT - http://www.ncbi.nlm.nih.gov/pubmed/22340145
ACT – https://contextualscience.org/act
10 StEP – http://pairadocks.blogspot.com/2015/04/the-10-steps-of-emotion-processing.html
MBBT – https://www.newharbinger.com/blog/introduction-mind-body-bridging-i-system
SEPT – https://en.wikipedia.org/wiki/Somatic_Experiencing
SMPT – https://en.wikipedia.org/wiki/Sensorimotor_psychotherapy
Find the full study in Schizophrenia Research (doi: 10.1016/j.schres.2015.10.016).