Insight in clinical psychiatry revisited

Current research on insight in psychiatry has focused on exploring the relationship between insight and other clinical variables such as severity of psychopathology, compliance with medication, general outcome, and, more recently, neuropsychological impairments. However, the studies yield divergent and inconsistent results, and consequently the role of insight in relation to such variables remains unclear. We review here recent studies in this area and suggest that one reason for variability in the results relates to confusion surrounding the term "insight." It is argued here that more conceptual work is needed to help clarify the meaning of insight before further empirical research is undertaken. Some of the conceptual issues are raised, and it is suggested that the concept of insight is first differentiated from the phenomenon of insight (its clinical representation) to facilitate a more structured and systematic approach to the examination of insight in clinical practice.