Awareness of own and others' schizophrenic illness

Several recent studies have suggested that poor insight among people suffering from schizophrenia is associated with low intelligence. On this basis, it was expected that schizophrenic patients with poor insight into their own illnesses would have greater difficulty in recognizing mental illness in others than patients with better insight. This hypothesis was tested with sets of eight hypothetical case descriptions (vignettes) which were first validated against the opinions of a group of qualified mental health professionals. Twenty-eight outpatients suffering from schizophrenia were then asked to rate the vignettes to indicate how likely it was that the individuals described had mental illnesses. The patients were divided into groups of high and low insight and their responses were compared with those of a group of matched normal controls. The results showed that both groups of patients could distinguish between descriptions of psychotic symptoms and normal thoughts, feelings and behaviours, and their opinions did not differ significantly from those of the controls or the professionals. Thus, insight into others' schizophrenic illness appears to be independent of insight into one's own illness. It seems that schizophrenic patients have little difficulty in applying consensual standards to experiences that reflect mental illness provided they are experiences of other people, even if they have great difficulty applying the same standards to their own experiences.