Assessment of insight in psychotic disorders

This paper presents a selected review of the concept insight as regards recognition of the presence of illness among patients with psychotic disorders in general and with schizophrenia in particular and the development of new instruments for its assessment. Lack of insight appears to be a common pathway for different psychopathological processes and may have different meanings in different stages of the illness. Three major dimensions of the concept include: (1) awareness of having a mental illness; (2) the need for treatment; and (3) relabeling symptoms and signs as pathological and attributed to a mental illness. This complexity must be addressed by studies with a design using instruments which are appropriate to the research goals and carefully identify the stage of illness of the target population.