In 16 inpatients with acute mania, neuropsychological evaluation revealed a trend toward correlation between less insight (lower scores on the Insight and Treatment Attitudes Questionnaire, ITAQ) and improved delayed visual recall. This result may either reflect the absence of a relationship between neuropsychological abnormalities and lack of insight in bipolar disorder, or it may represent an indirect expression of frontal lobe dysfunction. Also, an association was found between increased number of previous hospitalizations and greater insight. Since the neuropsychological result noted above was limited to patients with more than six previous hospitalizations, an interaction may exist between number of previous hospitalizations and neuropsychological abnormalities in the development of insight.