Catalina Crisan

By Cătălina Angela Crișan

Insight is a multidimensional construct, defined as the awareness of having a mental disorder, of specific symptoms and their attribution to the disorder, the awareness of social consequences, and of need for treatment. Although insight has been studied specifically in schizophrenia and its study in mood disorders has traditionally received limited attention, the evaluation of this concept in mood disorders is also very important because of the impact on treatment compliance and outcome. In bipolar disorder (BD), clinical insight varies substantially over time. Most researchers observed that insight is more impaired during an illness episode than during remission, in mixed than in pure manic episodes, in bipolar II than in bipolar I patients, and in pure mania than in bipolar or unipolar depression. Lack of insight is a consistent factor of non-adherence to medication in bipolar patients, along with severity of BD, side effects of medication, effectiveness, and patient-related factors. Also, impaired insight into treatment and a great number of previous hospitalizations are associated with poorer clinical outcomes (psychiatric hospitalization, emergency room visits, violent or suicidal behavior) among the patients with bipolar I disorder. In the management of bipolar disorder, improving quality of life (QoL) and outcome should be one the most important goals.

Part of the book: Psychotic Disorders

By Bianca Suciu and Cătălina-Angela Crișan

Eating disorders, which are well known as a substantial mental health problem in society, have been reclassified as feeding and eating disorders in DSM-5 and also in the 11th revision of ICD. The new classification includes binge eating disorder and avoidant-restrictive food intake disorder (ARFID), in addition to anorexia and bulimia nervosa. They are considered serious disorders, with high morbidity and mortality risks, that affect the young community in particular. Current research shows increases in all genders and age groups. Various genetic and biologic factors, an insecure personality type, impulsive traits, dysfunctional emotion regulation, and society’s ideal of slimness have been found to play a role in the development of these disorders. A dual approach with focus on the symptom and the underlying problems is needed for all types of eating disorders throughout the psychotherapeutic interventions. Assessing comorbid psychiatric and medical symptoms is extremely important. Further research and new directions of treatment are needed with regard to the expanded classifications.

Part of the book: Neurological and Mental Disorders