Insight and alexithymia in hospitalized psychiatric patients

The relationship of insight to the personality dimension of alexithymia was investigated in 91 psychiatric inpatients. Insight as a global construct and three subscales: the capacity to recognize that one has a psychiatric disorder, one needs treatment, and to label one's emotional illness as pathological were empirically measured via the Birchwood Scale for Insight. Alexithymia and its three subfactors were assessed by the 26-item Toronto Alexithymia Scale. Two of the alexithymia subfactors did correlate with reduced global insight and less acceptance of the need for therapy. Insight also correlated positively with the magnitude of depressed mood. In a regression model, depressed mood best predicted global insight. Other clinical variables, such as clinical severity upon admission, change in clinical status or diagnosis, did not predict insight levels. In summary, insight is a multidimensional phenomenon that does not simply correlate with alexithymia as a global construct but does correlate with alexithymic subfactor of diminished fantasy life.