Does insight affect long-term impatient treatment outcome in chronic schizophrenia?

The purpose of this study was to investigate whether the degree of insight into illness is associated with long-term inpatient treatment outcome in chronic schizophrenia. Inpatients diagnosed with schizophrenia were evaluated using the Global Assessment of Functioning Scale (GAF) and the Functional Skills Rating Form (FSRF) at baseline and at follow-up evaluation 1 year after treatment. The Scale to Assess Unawareness of Mental Disorder (SUMD) was used to evaluate insight into illness at follow-up evaluation. Pearson correlation coefficients were used to evaluate the relationship between insight and outcome variables, and multivariate analyses of variance (MANOVAs) were used to assess differences in treatment outcome between patients with good versus poor insight. The results suggest that a patient's insight is significantly related to global and specific measures of functional outcome. Moreover, patients with good insight showed better improvement after long-term inpatient treatment. These findings both support and expand on previous research indicating that increased insight into illness is associated with better treatment compliance and outcome. We propose that further research is necessary to specify the etiology of insight and to develop new interventions focused on increasing insight into illness.