The Effect Of Empathy On The Insight In Patients With First-episode Schizophrenia

Objective Empathy is refer to the ability to infer others’ psychological status including thought, intention, idea and emotional state, to predict the behavior of others, and to make appropriate response, while keeping a clear boundary between self and others. Large number of studies have found that empathy is impaired in many mental disorders, especially in patients with schizophrenia. schizophrenia is a chronic degenerative brain disease with unknown etiology, prominent clinical manifestation, also with obvious social dysfunction. They often show not only many abnormal symptoms, but with severely insight deficient. Many previous studies found that psychiatric symptoms and neurocognitive had certain impact on the insight, but cannot fully explain the defect of insight. The effect of empathy ability on patient’s insight are still poorly understood, this paper aims to investigate the effects of empathy on insight amony the first-episode schizophrenic patients.Methods Empathy with the Interpersonal Reactivity Index-C(IRI-C) and cognitive function with the Stroop color-word task, Trail making test, Digit span test were applied to 71 patients with first-episode schizophrenia and 69 healthy controls; in addition, schizophrenic patients were tested with Positive and Negative Syndrome Scale(PANSS) for scores of clinical symptoms and Scale of Unawareness of Mental Disorder(SUMD) for clinical insight.Results Compared with the control group, the schizophrenic patients showed lower subscores in the perspective taking [(13.85 ± 1.86) vs(6.74 ± 2.56), P<0.01], empathic concern [(14.28 ± 2.16) vs(17.49 ± 2.73), P<0.01] of IRI-C, but higher subscale score [(10.28 ± 2.78) vs(8.93 ± 1.93), P<0.01] in personal distress. In addition, A significant difference(P<0.01) were found on the scores of the Stroop task, trail making test and digit span test between schizophrenic patients and health controls. Pearson correlation analysis showed that, there were negatively significant correlations between insight score and perspective taking(r=-0.429, P<0.01), empathic concern(r=-0.709, P<0.01) subscores of IRI-C respectively. In addition, the insight total score was positively correlated with reaction time of C part(r=0.510, P<0.01) of Stroop task, reaction time of B part(r=0.479, P<0.01) of trail making test and the positive symptoms subscore(r=0.545, P<0.01) of PANSS respectively, but negatively correlated with subscore(r=-0.508, P<0.01) of digit span test(reverse part).Conclusion Patients with first-episode schizophrenia had significant empathy defects. And the empathic deficits were associated with the insight impairment among the schizophrenic patients, suggesting that the empathy may be an important predicator of their insight level.