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Insight and clinical correlates in schizophrenia

Y Kim1, K Sakamoto, T Kamo

  • 1Division of Adult Mental Health, National Institute of Mental Health of Japan, Ichikawa, Japan.

Comprehensive Psychiatry
|March 1, 1997
PubMed
Summary

Poor insight in schizophrenia may be linked to acute phases and later onset, not chronic illness. Outpatient settings may improve treatment awareness despite poor illness insight.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Insight in schizophrenia is complex, influenced by psychopathology and clinical factors.
  • Understanding intact insight is crucial for schizophrenia treatment.
  • Differentiating inherent psychopathology from clinical factors affecting insight is key.

Purpose of the Study:

  • To investigate the extent to which poor insight in schizophrenia is inherent versus related to clinical factors.
  • To explore the relationship between specific psychopathological symptoms, subjective experiences, and treatment settings with insight.
  • To determine factors influencing awareness of illness, psychotic experiences, and need for treatment.

Main Methods:

  • Sixty-three patients diagnosed with ICD-10 schizophrenia were recruited.

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  • Insight was assessed using David's three-dimensional scale (awareness of illness, treatment need, psychotic experiences).
  • Clinical factors included objective psychopathology (BPRS, SANS), subjective experience, and treatment setting (inpatient/outpatient).

    • Main Results:

    • Positive symptoms correlated inversely with awareness of illness and psychotic experiences.
    • Later age at first onset correlated with poor awareness of psychotic experiences.
    • Awareness of the need for treatment was higher in outpatients and unrelated to other insight dimensions.

    Conclusions:

    • Poor awareness of illness and psychotic experiences appears characteristic of acute schizophrenia, not chronic.
    • Later onset of schizophrenia is associated with poorer awareness of psychotic experiences.
    • Outpatient settings may foster treatment-seeking behavior independently of insight into illness.