Abstract
The concept of insight and its relationship to mental disorders is most frequently understood as a conscious recognition of one's own mental state or the degree of personal awareness or self-understanding (Lysaker et al., 2013). In recent research, insight is most frequently studied in schizophrenia patients and disturbances of self-awareness and conscious experience might have a critical role in pathophysiology of schizophrenia (Bob et al., 2016).
Current findings also suggest that changes of the HPA axis (hypothalamus-pituitary-adrenal) might be present in patients with first episode psychotic disorders (Pruessner et al., 2017). There are studies focusing on cortisol levels changes as a response to acute stress in patients with psychosis but only few studies provide results about cumulative (long term) cortisol secretion in patients prior to the first episode of psychosis (Walker et al., 2008).
To reflect the long term cortisol secretion, hair cortisol analysis seems to be a new methodological development capturing the cortisol levels over extended period of hair growth robust against several variations (Stalder et al., 2017). With respect to the recent findings we have tested a hypothesis of a relationship between insight deficits and psychotic symptoms, and their links to long term cortisol secretion.