{"doi":"10.1093/schbul/sbaf019","title":"Insight and Its Trajectory: Predicting the Risk of Psychiatric Hospitalizations Among First-Episode Psychosis During the First Year of Coordinated Specialty Care","abstract":"BACKGROUND: This study explored how baseline insight predicts psychiatric hospitalization risk among 186 individuals with first-episode psychosis in coordinated specialty care (CSC). We hypothesized that insight, a potentially modifiable factor, moderates the relationship between CSC enrollment and outcomes, with a high baseline and stable high insight predicting greater reductions in hospitalizations and lengths of stay (LOS). DESIGN: Insight was assessed using the G12 item of the positive and negative syndrome scale, categorizing participants into low (G12 ≥ 4; n = 87) or high (G12 < 4; n = 99) insight groups at baseline. Six longitudinal trajectories were identified: stable high (n = 48), increasing (n = 41), declining (n = 31), stable low (n = 27), high-low-high (n = 20), and low-high-low (n = 19). Hospitalization data were collected for 12 months pre- and post-CSC enrollment. RESULTS: Participants with high baseline insight demonstrated a 95% greater relative reduction in hospitalizations (relative risk reduction = 1.95, P = .002), indicating that insight moderated the relationship between CSC enrollment and hospitalization outcomes. Longitudinally, the stable high insight group exhibited the most substantial reductions in hospitalizations (risk ratio [RR] = 0.12, P < .001) and LOS (RR = 0.04, P < .001), outperforming the stable low and fluctuating insight groups. CONCLUSION: Insight moderates the relationship between CSC enrollment and hospitalization outcomes, predicting clinical improvements in early psychosis. Interventions targeting insight may enhance CSC benefits by reducing hospitalizations and improving recovery trajectories.","journal":"Schizophrenia Bulletin","year":2025,"id":533525,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9639,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":472775,"name":"Maria Ferrara","orcid":"0000-0003-2143-1101","position":1,"is_corresponding":false},{"id":1313478,"name":"Toni Gibbs-Dean","orcid":"0009-0005-1312-5608","position":2,"is_corresponding":false},{"id":1313479,"name":"Sümeyra N. Tayfur","orcid":"0000-0002-5151-850X","position":3,"is_corresponding":false},{"id":466053,"name":"Sílvia Corbera","orcid":"0000-0002-5090-2462","position":4,"is_corresponding":false},{"id":1313827,"name":"Sneha Karmani","orcid":null,"position":5,"is_corresponding":false},{"id":1410810,"name":"Zhiqian Song","orcid":"0009-0009-4083-0723","position":6,"is_corresponding":false},{"id":517793,"name":"Fangyong Li","orcid":"0000-0003-3171-7592","position":7,"is_corresponding":false},{"id":1415321,"name":"Ilias I. Vlachos","orcid":"0000-0001-9044-7081","position":8,"is_corresponding":false},{"id":1415322,"name":"Mirjana Selaković","orcid":"0000-0001-7278-528X","position":9,"is_corresponding":false},{"id":472776,"name":"Cenk Tek","orcid":"0000-0002-3439-1914","position":10,"is_corresponding":false},{"id":472774,"name":"Vinod H. Srihari","orcid":"0000-0003-1556-2332","position":11,"is_corresponding":false},{"id":1003015,"name":"Hadar Hazan","orcid":"0000-0001-7846-9624","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T02:51:32.301795Z","pmid":"40227145","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}