Work rehabilitation and improvements in insight in schizophrenia

Research has suggested that impaired insight in patients with schizophrenia is associated with poorer treatment compliance and outcome. Little is known about what forms of treatment can lead to improvements in insight. Research has found that impairments in insight remain stable despite participation in standard treatments. This study examined changes in insight in a sample of 44 subjects with impaired insight who were enrolled in a vocational rehabilitation program. Significant improvements in insight rating were observed for the sample, with a total of 61% of subjects (N = 27) improving. Multiple regression analysis revealed that measures of cognitive impairment (Digit Symbol Subtest Test, Slosson IQ Test, Wisconsin Card Sorting Test) predicted improvement in insight (R2 = .33), with greater levels of cognitive impairments predicting lesser improvement. Psychosocial variables, including concurrent measurements of positive and negative symptoms, were not significant predictors of improvement. These results suggest that vocational rehabilitation can favorably affect insight, particularly for subjects with less severe cognitive deficits.