[Unawareness in brain disorders: a complex and multifaceted phenomenon]

Area of Science:

• Neurology
• Neuropsychology
• Psychopathology
• Psychosocial Health

Background:

• Unawareness of disease or its consequences can be a psychological defense mechanism.
• However, this unawareness can also lead to dangerous behaviors and hinder effective care management.
• The complex nature of unawareness, involving neurological, neuropsychological, psychopathological, and psychosocial dimensions, remains poorly understood.

Purpose of the Study:

• To explore the multidimensional construct of unawareness.
• To challenge the categorical view of unawareness, highlighting its partial and dimensional nature.
• To propose an integrative approach for assessing and managing unawareness.

Main Methods:

• Review of existing literature on unawareness and its assessment.
• Analysis of the limitations of current assessment methods, noting weak correlations between different approaches.
• Conceptualization of unawareness as a multidimensional phenomenon.

Main Results:

• Unawareness is a complex, multidimensional construct, not a simple categorical phenomenon.
• Current assessment methods show limited correlation, suggesting a need for a more comprehensive approach.
• The distinction between neurological (anosognosia) and psychopathological (denial) perspectives is insufficient.

Conclusions:

• An integrative approach, combining neurological and psychopathological perspectives, is crucial for understanding unawareness.
• Recognizing unawareness as partial and dimensional allows for better adaptation of care management strategies.
• Further research is needed to develop and validate integrated assessment tools for unawareness.