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Tijdschrift voor Psychiatrie 46 (2004) 9, 589 - 599

New research

Insight of schizophrenic patients into their disorder

C. Matton, M. Wampers, M. De Hert, J. Peuskens

background Schizophrenic patients often lack awareness of their disorder. This can have a marked influence on their compliance with treatment, psychosocial functioning and the final outcome.
aim To study the relationship between patients' insight into their disorder and demographic variables and between patient's insight and symptoms, and to evaluate how patients' insight evolved over a one-year period.
method Demographic variables and data on symptoms and on patients' insight into their disorder were collected for 679 psychotic inpatients in 15 Belgian hospitals by means of the 'Psychosis Evaluation tool for Common use by Caregivers'. Relationships were computed using Spearman correlations.
results This study identified a number of variables that influence patients' insight into their disorder, namely iq, educational level and symptomatology (positive, negative, affective and cognitive symptoms). All of these variables can affect patients' awareness of their disorder. At the one-year follow-up there was also a significant correlation between changes in insight and changes in general psychopathology.
conclusion The results show a correlation between insight into the disorder and iq, educational level and symptoms. The correlation between insight and positive symptoms and between insight and general psychopathology still existed at the one-year follow-up. However, the observed correlations are very modest. Apparently, factors other than the severity of symptoms contribute to patients' lack of insight. Recent research has revealed a strong association between levels of executive functioning and lack of insight. There is an urgent need for further investigations into the influence that cognitive deficits can have on insight; these will have to be performed using reliable and valid measuring instruments.

keywords insight, psychosis, schizophrenia, symptoms