A comparison between an interview and a self-report method of insight assessment in chronic schizophrenia

We examined the relationship between a researcher-rated and a self-report method of insight assessment in patients with schizophrenia. Previous research has established that a moderate correlation exists between several researcher-rated and self-report insight scales. Hence, we wanted to investigate this association using another combination of assessment techniques. Accordingly, 34 patients with chronic schizophrenia were administered the Scale to Assess Unawareness of Mental Disorder (SUMD) and the Birchwood self-report Insight Scale (IS). We found a significantly lower report of insight on the Birchwood IS, regardless of administration order. These findings suggest that inherent bias within the patient-examiner interaction may be responsible for this discrepancy. Overall, a significant positive correlation was observed between total scores on the SUMD and the Birchwood self-report IS. Unexpectedly, there was a remarkable difference in correlation with respect to the order of test administration. The "self-report first" group's scores were strongly correlated, whereas the "researcher-rated first" group's scores showed little relation. These results demonstrate the importance of investigating the effects of administration order, and also question the reliability of other correlational studies between researcher-rated and self-report insight scales that have failed to employ a counterbalanced research design.