Insight in psychosis: a systematic review of treatment interventions

Insight into illness is often impaired in psychosis and associated with poor prognosis, yet little is known about how to improve insight. After an examination of the conceptual background of insight, we review the limited empirical studies of this topic. Six studies of psychoeducation are mixed, though suggesting a possible benefit, especially with individualized interventions. In 2 studies of psychoanalytically oriented psychotherapy, and 1 of cognitive-behavioral psychotherapy, no beneficial effect on insight was notable. Two studies each of videotaped self-observation and antipsychotic medication reported improvement in insight. The possibility that atypical antipsychotics may be especially beneficial compared to traditional antipsychotics deserves further examination. We conclude that this literature suggests potentially useful options for clinicians, but further research is needed with better validated insight scales.