A note on judgment and insight in psychiatric disability

Reports which include unsupported statements about insight and judgment may delay, and render more difficult, the ultimate decision as to entitlement of patients to benefits under various programs. Such statements should be associated with clinical data which adequately support the statement. Insight usually has very little bearing on the clinical evidence of loss of function resulting from psychiatric illness. Its use may be justified in those few instances where it has a direct bearing on prognosis. Judgment as a concept in the evaluation of psychiatric illness should be specifically restricted to that area of judgment which is associated with the patient's usual and customary level of adjustment in a work situation. This evaluation of judgment as a general concept is based upon many variable and complex factors which do not readily lend themselves to routine adjudication of judgment in the ordinary psychiatric evaluation. The psychiatrist might be more effective in his reporting if he were to avoid generalizing about insight and judgment where insufficient data prevents the forming of a definite opinion.