A Comparative Analysis of the Levels of Insight Between Elderly and Nonelderly Patients Diagnosed With Schizophrenia

The aim of this study was to examine various dimensions of insight among elderly and nonelderly patients with schizophrenia.

Disease insight was assessed in 105 patients using the Self-Appraisal of Illness Questionnaire (SAIQ), while disease severity was assessed using the Positive and Negative Syndrome Scale (PANSS). Results were compared among 3 age groups: 20 to 39 years (young), 40 to 59 years (middle-aged), and 60 years or above (older), using the Kruskal-Wallis test. Factors associated with insight were identified by constructing a multiple linear regression model.

Total PANSS scores did not differ significantly among the age groups. The total SAIQ score was significantly higher in the young and middle-aged groups compared with the older group (P = 0.011 and 0.024). The SAIQ Worry subscale score was significantly higher in the young group than in the older group (P = 0.021), while the Presence of Illness subscale scores were higher in both the young and middle-aged groups than in the older group (P = 0.017 and 0.041). Multiple linear regression identified older age (P = 0.024) and higher PANSS negative symptom scores (P = 0.041) as significantly associated with lower SAIQ scores.

Among those with a similar severity of disease, individuals with schizophrenia aged 60 years and older displayed the lowest levels of insight. This older cohort exhibited reduced concern regarding the impact of the illness on their social and occupational functioning and tended to underestimate the severity of their condition. In addition to age, negative symptoms of schizophrenia may also play a significant role in the relationship with deficits in insight.